Provider Demographics
NPI:1316658669
Name:LOW, MEILANI KERRI (AMFT)
Entity type:Individual
Prefix:
First Name:MEILANI
Middle Name:KERRI
Last Name:LOW
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 EL CAMINO REAL STE 213
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3656
Mailing Address - Country:US
Mailing Address - Phone:714-805-6510
Mailing Address - Fax:
Practice Address - Street 1:11710 SAN VICENTE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-5006
Practice Address - Country:US
Practice Address - Phone:855-651-1580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA135521106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist