Provider Demographics
NPI:1124703244
Name:PACHECO, CESAR A (LMFT)
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:A
Last Name:PACHECO
Suffix:
Gender:M
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:PO BOX 1655
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92822-1655
Mailing Address - Country:US
Mailing Address - Phone:949-407-9882
Mailing Address - Fax:
Practice Address - Street 1:17291 IRVINE BLVD STE 258
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-2949
Practice Address - Country:US
Practice Address - Phone:949-407-9882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-16
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140672106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist