Provider Demographics
NPI:1871626556
Name:CARNEY, PRYNZESSIN NICOLE (LMFT)
Entity type:Individual
Prefix:MS
First Name:PRYNZESSIN
Middle Name:NICOLE
Last Name:CARNEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 REDONDO AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814-7086
Mailing Address - Country:US
Mailing Address - Phone:909-496-6636
Mailing Address - Fax:
Practice Address - Street 1:23201 MILL CREEK DR STE 220
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-7906
Practice Address - Country:US
Practice Address - Phone:909-496-6636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28005167G00000X
CA111506106H00000X
CAIMF 85191106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No167G00000XNursing Service ProvidersLicensed Psychiatric Technician