Provider Demographics
NPI:1316400641
Name:NIEGA, XYNTIER PATRICK (LMFT)
Entity type:Individual
Prefix:MR
First Name:XYNTIER
Middle Name:PATRICK
Last Name:NIEGA
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:MR
Other - First Name:PATRICK
Other - Middle Name:IGHARAS
Other - Last Name:NIEGA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:10441 TIARA ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-1524
Mailing Address - Country:US
Mailing Address - Phone:818-679-2066
Mailing Address - Fax:
Practice Address - Street 1:16461 SHERMAN WAY STE 155
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3840
Practice Address - Country:US
Practice Address - Phone:888-795-4337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-12
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104989106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist