Provider Demographics
NPI:1871892935
Name:FRANCO, MARISELA (LMFT)
Entity type:Individual
Prefix:
First Name:MARISELA
Middle Name:
Last Name:FRANCO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 PACIFIC AVE UNIT 4162
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-7006
Mailing Address - Country:US
Mailing Address - Phone:209-898-8399
Mailing Address - Fax:
Practice Address - Street 1:2616 PACIFIC AVE UNIT 4162
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-7006
Practice Address - Country:US
Practice Address - Phone:209-898-8399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-15
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA98052106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist