Provider Demographics
NPI:1851149082
Name:LANTERNIER, MICHELLE MARTINE (MFT TRAINEE)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARTINE
Last Name:LANTERNIER
Suffix:
Gender:F
Credentials:MFT TRAINEE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 E ORANGETHORPE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831-5205
Mailing Address - Country:US
Mailing Address - Phone:714-469-1323
Mailing Address - Fax:
Practice Address - Street 1:1501 E ORANGETHORPE AVE STE 200
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-5205
Practice Address - Country:US
Practice Address - Phone:714-254-8473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-13
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program