Most Relevant Information
Provider Data
| NPI Number: | 1003534900 |
| Provider Name: | MARI KONOSHIMA ANDERSEN |
| Entity Type: | Individual |
| Taxonomy Code: | 106H00000X |
| Specialty: | Marriage & Family Therapist |
| License Number: | 132206 |
Most Important Dates
| Enumeration Date: | 08/16/2022 |
| Last Updated: | 08/16/2022 |
Provider Practice Location
3551 CAMINO MIRA COSTA STE T
SAN CLEMENTE
CA
926723508
Practice Location Phone/Fax
| Phone: | 9492724444 |
| Fax: |
Provider Mailing Location
1058 LA MIRADA ST
LAGUNA BEACH
CA
926513570
Provider Mailing Phone/Fax
| Phone: | 9492281662 |
| Fax: |