Provider Demographics
NPI:1962049015
Name:OZENBAUGH, DEANNA (LMFT)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:OZENBAUGH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19681 CRESTKNOLL DR
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-6403
Mailing Address - Country:US
Mailing Address - Phone:714-624-6117
Mailing Address - Fax:
Practice Address - Street 1:18300 YORBA LINDA BLVD STE 203
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-4052
Practice Address - Country:US
Practice Address - Phone:714-646-8034
Practice Address - Fax:714-492-8264
Is Sole Proprietor?:No
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT28001106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist