Provider Demographics
NPI:1053672071
Name:SHUGARMAN, MARK (LMFT)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:SHUGARMAN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 S. GRAND AVE
Mailing Address - Street 2:BLDG C, SUITE 213W
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705
Mailing Address - Country:US
Mailing Address - Phone:657-427-0559
Mailing Address - Fax:
Practice Address - Street 1:1300 S. GRAND AVE
Practice Address - Street 2:BLDG C, SUITE 213W
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-9270
Practice Address - Country:US
Practice Address - Phone:657-427-0559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94552106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist