Provider Demographics
NPI:1871703793
Name:BATTISTONE, LOUIS (MA, LMFT, CATC)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:BATTISTONE
Suffix:
Gender:M
Credentials:MA, LMFT, CATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11777 SEBASTIAN WAY STE 102B
Mailing Address - Street 2:SUITE 204
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-5729
Mailing Address - Country:US
Mailing Address - Phone:909-989-9724
Mailing Address - Fax:909-989-0249
Practice Address - Street 1:11777 SEBASTIAN WAY STE 102B
Practice Address - Street 2:SUITE 204
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-0707
Practice Address - Country:US
Practice Address - Phone:909-989-9724
Practice Address - Fax:909-989-0249
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT45786106H00000X
CACATCT B0504111305101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)