Provider Demographics
NPI:1285895110
Name:SERRANO, ROGELIO (LMFT)
Entity type:Individual
Prefix:
First Name:ROGELIO
Middle Name:
Last Name:SERRANO
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 1:1940 W ORANGEWOOD AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-2009
Mailing Address - Country:US
Mailing Address - Phone:714-437-7693
Mailing Address - Fax:714-744-1830
Practice Address - Street 1:1940 W ORANGEWOOD AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2009
Practice Address - Country:US
Practice Address - Phone:714-437-7693
Practice Address - Fax:714-744-1830
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC42176106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist