LOLETA MICHELLE GUSTAFSON (NPI# 1033475108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033475108 |
| Entity Type | Individual |
| Full Name | LOLETA MICHELLE GUSTAFSON |
| Credential | LMFT, M.S. |
| Practice Address |
34455 Yucaipa Blvd Ste 206 Yucaipa CA 92399 |
| Mailing Address |
Po Box 882 Yucaipa CA 92399-0882 |
| Practice Telephone | 9097903900 |
| Mailing Telephone | 9092830997 |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2019-10-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 49983 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LMFT | 44983 | 01 |
| CA | CAMFT | 44983 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 13193 Central Ave Ste 220, Chino, CA 917104179 | 9099049500 |
| Street Address |
34455 YUCAIPA BLVD STE 206 |
| City | YUCAIPA |
| State | CA |
| Zip Code | 92399 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003284514 | Footprints Counseling Services | Marriage & Family Therapist | 34455 Yucaipa Blvd Ste 206, Yucaipa, CA 92399-2476 | 2015-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891301941 | Emily Ambrosi | Occupational Therapist | 12257 Tulip Ln, Yucaipa, CA 92399 | 2020-09-23 |
| 1952943524 | Terrence Williams | Behavioral Analyst | 13768 Meadow View Lane, Yucaipa, CA 92399 | 2019-10-15 |
| 1235795097 | Han Acu&herbs, Inc | Acupuncturist | 32387 Yucaipa Blvd, Ste, F, Yucaipa, CA 92399 | 2019-05-16 |
| 1366926784 | David Gene Satre | Psychologist | 31752 Dove Ct, Yucaipa, CA 92399 | 2018-09-21 |
| 1336659861 | Titianna Little | Physical Therapist | 32819 Yucaipa Boulevard #3, Yucaipa, CA 92399 | 2017-10-11 |
| 1174043467 | Sharon Lee Pendola | Licensed Vocational Nurse | 11885 4th St, Yucaipa, CA 92399 | 2017-06-27 |
| 1073033072 | Juniper Manor, LLC | Skilled Nursing Facility | 35223 Juniper Avenue, Yucaipa, CA 92399 | 2017-06-21 |
| 1952858417 | Rafael Arias | Non-emergency Medical Transport (VAN) | 12386 17th St, Yucaipa, CA 92399 | 2016-09-01 |
| 1578906467 | Joyce I Bandele | Durable Medical Equipment & Medical Supplies | 34664 County Line Rd Suite 14, Yucaipa, CA 92399 | 2013-04-10 |
| 1750674834 | Oxana Teppone-martin | Registered Nurse | 33915 Pinehurst Dr, Yucaipa, CA 92399 | 2011-05-23 |
| Find all providers in zip 92399 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952691644 | Amanda Cavicchi | Marriage & Family Therapist | 13518 Fremont St, Yucaipa, CA 92399-5523 | 2011-04-14 |
| 1831496439 | Joshua Trent Vander Veen | Marriage & Family Therapist | 34455 Yucaipa Blvd # 205206, Yucaipa, CA 92399-2475 | 2011-02-16 |
| 1164675328 | Priscilla J. Baudoin | Marriage & Family Therapist | 35393 Avenue E, Yucaipa, CA 92399-4828 | 2008-10-30 |
| 1346440633 | Lynn Helen Sinjem | Marriage & Family Therapist | 34590 County Line Rd Ste 8, Yucaipa, CA 92399-5398 | 2007-07-24 |
| 1205053253 | Vernon R Bradley | Marriage & Family Therapist | 35249 Yucaipa Blvd, Suite B, Yucaipa, CA 92399-4340 | 2007-04-19 |
| 1376173021 | Katelynn Marie Scott | Marriage & Family Therapist | 34324 Yucaipa Blvd Ste C, Yucaipa, CA 92399-2496 | 2020-01-22 |
| 1093203804 | Alexey Blames | Marriage & Family Therapist | 10776 Fremont St, Yucaipa, CA 92399-9630 | 2018-04-26 |
| 1700396702 | Zuleyma Mendez | Marriage & Family Therapist | 34324 Yucaipa Blvd Ste C, Yucaipa, CA 92399-2496 | 2017-10-04 |
| 1447600085 | Samuel Evan Moore | Marriage & Family Therapist | 10776 Fremont St, Yucaipa, CA 92399-9630 | 2016-06-14 |
| 1003284514 | Footprints Counseling Services | Marriage & Family Therapist | 34455 Yucaipa Blvd Ste 206, Yucaipa, CA 92399-2476 | 2015-09-14 |
| Find all providers in YUCAIPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.