Provider Demographics
NPI:1427759810
Name:ARTIGUE, JONATHAN EDWARD (LMFT)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:EDWARD
Last Name:ARTIGUE
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 1:16638 VAN NESS AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-2200
Mailing Address - Country:US
Mailing Address - Phone:310-200-9352
Mailing Address - Fax:
Practice Address - Street 1:1310 W PEARL ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5940
Practice Address - Country:US
Practice Address - Phone:714-780-1174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA125131106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist