Healthcare Provider Details

I. General information

NPI: 1801431341
Provider Name (Legal Business Name): VICTORIA RAE STORR LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2019
Last Update Date: 11/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

447 SUTTER ST. STE 429
SAN FRANCISCO CA
94108
US

IV. Provider business mailing address

447 SUTTER ST STE 429
SAN FRANCISCO CA
94108-4630
US

V. Phone/Fax

Practice location:
  • Phone: 530-329-2400
  • Fax:
Mailing address:
  • Phone: 530-329-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number111000
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: