Most Relevant Information
Provider Data
| NPI Number: | 1003318023 |
| Provider Name: | IVANNIA FUENTES |
| Entity Type: | Individual |
| Taxonomy Code: | 106H00000X |
| Specialty: | Marriage & Family Therapist |
| License Number: | 133530 |
Most Important Dates
| Enumeration Date: | 03/06/2018 |
| Last Updated: | 07/06/2022 |
Provider Practice Location
5150 E PACIFIC COAST HWY STE 100
LONG BEACH
CA
908043394
Practice Location Phone/Fax
| Phone: | 5624907600 |
| Fax: | 5624907601 |
Provider Mailing Location
5150 E PACIFIC COAST HWY STE 100
LONG BEACH
CA
908043394
Provider Mailing Phone/Fax
| Phone: | 5624907600 |
| Fax: | 5624907601 |