1205975307 NPI number — MRS. ALFREDA LOUISE VOLBERDING MARITAL FAMILY THERA

Table of content: MRS. ALFREDA LOUISE VOLBERDING MARITAL FAMILY THERA (NPI 1205975307)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205975307 NPI number — MRS. ALFREDA LOUISE VOLBERDING MARITAL FAMILY THERA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VOLBERDING
Provider First Name:
ALFREDA
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MARITAL FAMILY THERA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VOLBERDING MFT
Provider Other First Name:
FREDI
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MARITAL FAMILY THERA
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1205975307
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19742 MACARTHUR BLVD
Provider Second Line Business Mailing Address:
STE 145
Provider Business Mailing Address City Name:
IRVINE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92612
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-476-8221
Provider Business Mailing Address Fax Number:
949-759-1681

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19742 MACARTHUR BLVD
Provider Second Line Business Practice Location Address:
STE 145
Provider Business Practice Location Address City Name:
IRVINE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-476-8221
Provider Business Practice Location Address Fax Number:
949-759-1681
Provider Enumeration Date:
02/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  LMFT 29745 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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