Provider Demographics
NPI:1093029043
Name:BRANCH, MICHELE CYNS (MFT)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:CYNS
Last Name:BRANCH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6311 LARCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-2320
Mailing Address - Country:US
Mailing Address - Phone:714-894-7212
Mailing Address - Fax:
Practice Address - Street 1:6311 LARCHWOOD DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-2320
Practice Address - Country:US
Practice Address - Phone:714-894-7212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42033106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist