Provider Demographics
NPI:1548033921
Name:REITSMA, CAROLE LEE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:CAROLE
Middle Name:LEE
Last Name:REITSMA
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 1:926 3RD ST
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-2737
Mailing Address - Country:US
Mailing Address - Phone:714-356-8188
Mailing Address - Fax:
Practice Address - Street 1:926 3RD ST
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-2737
Practice Address - Country:US
Practice Address - Phone:714-356-8188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT37365106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist