Basic Information
| Provider Information | |||||||||
| NPI: | 1457865537 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OROZCO | ||||||||
| FirstName: | MICHELLE | ||||||||
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| Credential: | MFT-I | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9652 MADRONA DR | ||||||||
| Address2: | |||||||||
| City: | FONTANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923355602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9097820000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3569 LEXINGTON AVE | ||||||||
| Address2: | |||||||||
| City: | EL MONTE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917312607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6264533399 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/28/2017 | ||||||||
| LastUpdateDate: | 11/28/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 102328 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.