Gustafson, Loleta Michelle

Gustafson, Loleta Michelle is an sole proprietor health care provider with primary practice located at 34455 Yucaipa Blvd Ste 206 , Yucaipa CA 92399. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Gustafson, Loleta Michelle can be contacted via phone (909) 790-3900.

Contact Information

Primary practice address
34455 Yucaipa Blvd Ste 206 Yucaipa CA 92399
Phone: (909) 790-3900
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 49983 California

Profile Details

NPI number 1033475108
LBN Legal business name Gustafson, Loleta Michelle
Credentials LMFT, M.S.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 3rd, 2012
Last updated Oct 25th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033475108 NPPES
California Other 44983 CAMFT
California Other 44983 CAMFT

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