Provider Demographics
NPI:1992117949
Name:CARPENA, ANN (LMFT)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:CARPENA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:TABANGCURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:954 W FOOTHILL BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-3782
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:954 W FOOTHILL BLVD STE A
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3782
Practice Address - Country:US
Practice Address - Phone:909-946-4222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-27
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X, 106H00000X
CA109008106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program