Provider Demographics
NPI:1952749145
Name:CRANE, MARYBETH SIMONTON (LMFT)
Entity type:Individual
Prefix:MS
First Name:MARYBETH
Middle Name:SIMONTON
Last Name:CRANE
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 1:225 SIMI VILLAGE DR
Mailing Address - Street 2:#940056
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93094-7001
Mailing Address - Country:US
Mailing Address - Phone:805-390-4528
Mailing Address - Fax:805-426-4898
Practice Address - Street 1:1227 E LOS ANGELES AVE
Practice Address - Street 2:VCBH ADULT SERVICES
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-2871
Practice Address - Country:US
Practice Address - Phone:805-390-4528
Practice Address - Fax:805-426-4898
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 52853106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist