Provider Demographics
NPI:1881160430
Name:CHOLULA BRUNO, ARELY (LMFT)
Entity type:Individual
Prefix:
First Name:ARELY
Middle Name:
Last Name:CHOLULA BRUNO
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 1:600 W SANTA ANA BLVD STE 530
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-4551
Mailing Address - Country:US
Mailing Address - Phone:714-299-3896
Mailing Address - Fax:
Practice Address - Street 1:600 W SANTA ANA BLVD STE 530
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-4551
Practice Address - Country:US
Practice Address - Phone:714-299-3896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-22
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA109188106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist