Provider Demographics
NPI:1689018533
Name:LANNING, BECKY NICOLE (LMFT)
Entity type:Individual
Prefix:
First Name:BECKY
Middle Name:NICOLE
Last Name:LANNING
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 1:21661 BROOKHURST ST APT 90
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-8114
Mailing Address - Country:US
Mailing Address - Phone:760-908-9137
Mailing Address - Fax:
Practice Address - Street 1:1012 MAIN ST
Practice Address - Street 2:#101
Practice Address - City:RAMONA
Practice Address - State:CA
Practice Address - Zip Code:92065-2170
Practice Address - Country:US
Practice Address - Phone:760-788-9724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114012106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist