Basic Information
| Provider Information | |||||||||
| NPI: | 1164613683 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DE COU FRONKOVIAK | ||||||||
| FirstName: | APRIL | ||||||||
| MiddleName: | |||||||||
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| OtherLastName: | DE COU | ||||||||
| OtherFirstName: | APRIL | ||||||||
| OtherMiddleName: | JEAN | ||||||||
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| OtherCredential: | LMFT 23445 | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 26646 DOROTHEA | ||||||||
| Address2: | |||||||||
| City: | MISSION VIEJO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926915902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9495823012 | ||||||||
| FaxNumber: | 9495823012 | ||||||||
| Practice Location | |||||||||
| Address1: | 1900 E LA PALMA AVE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928051647 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7143993480 | ||||||||
| FaxNumber: | 7143993481 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2007 | ||||||||
| LastUpdateDate: | 08/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 23445 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.