Provider Demographics
NPI:1699028134
Name:BORING-BRAY, WENDY (LPCC)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:
Last Name:BORING-BRAY
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:BRAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCC
Mailing Address - Street 1:PO BOX 224
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-0224
Mailing Address - Country:US
Mailing Address - Phone:949-562-8004
Mailing Address - Fax:
Practice Address - Street 1:26040 ACERO STE 207
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-2768
Practice Address - Country:US
Practice Address - Phone:949-562-8004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-22
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012013277101YP2500X
CALPCC7701101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional