Healthcare Provider Details

I. General information

NPI: 1083972798
Provider Name (Legal Business Name): ELISABETH LHOEST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2012
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 SANTA CLARA AVE STE 205
OAKLAND CA
94610-1323
US

IV. Provider business mailing address

1117 NEILSON ST
ALBANY CA
94706-2433
US

V. Phone/Fax

Practice location:
  • Phone: 510-601-1929
  • Fax: 510-660-1194
Mailing address:
  • Phone: 415-235-0949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number146631
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: