Provider Demographics
NPI:1366720583
Name:FIORENTINI, ELIO PAOLO
Entity type:Individual
Prefix:MR
First Name:ELIO
Middle Name:PAOLO
Last Name:FIORENTINI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 S GRAND AVE STE B
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-4121
Mailing Address - Country:US
Mailing Address - Phone:714-667-7781
Mailing Address - Fax:
Practice Address - Street 1:800 N ECKHOFF ST STE 4130
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-1008
Practice Address - Country:US
Practice Address - Phone:714-704-8219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94340106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist