Individual provider · Type 1 NPI

Ana Lisa De la Fuente

Mental Health Counselor · Mount Shasta, CA

NPI number 1104941756 Active

Practice location

1107 Ream Ave
Mount Shasta, CA 96067-9768

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1104941756

Ana Lisa De la Fuente's National Provider Identifier is 1104941756, issued on Mar 20, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Mount Shasta, CA. The record was last updated on Mar 13, 2008.