Provider Demographics
NPI:1447548532
Name:EGUINO, ROSARIO (MFT)
Entity type:Individual
Prefix:MS
First Name:ROSARIO
Middle Name:
Last Name:EGUINO
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4616 WELCH PL #3
Mailing Address - Street 2:
Mailing Address - City:LA
Mailing Address - State:CA
Mailing Address - Zip Code:90027
Mailing Address - Country:US
Mailing Address - Phone:213-924-2096
Mailing Address - Fax:323-668-2472
Practice Address - Street 1:4616 WELCH PL #3
Practice Address - Street 2:
Practice Address - City:LA
Practice Address - State:CA
Practice Address - Zip Code:90027
Practice Address - Country:US
Practice Address - Phone:213-924-2096
Practice Address - Fax:323-668-2472
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT29006106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist