Provider Demographics
NPI:1053402602
Name:FALKINBURG, ANN MARIE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:MARIE
Last Name:FALKINBURG
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 1:1464 SUNRISE CIR S
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91784-7327
Mailing Address - Country:US
Mailing Address - Phone:909-949-1345
Mailing Address - Fax:
Practice Address - Street 1:9890 COUNTY FARM RD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3505
Practice Address - Country:US
Practice Address - Phone:951-358-4850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 24415106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist