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General NPI Number Information
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NPI Number | 1144369257
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Entity Type | Individual
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Provider Name | LISE SERRIE STERN MFT
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Gender | Female
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 609 KEARNEY ST
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City | EL CERRITO
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State | CA
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Zip | 94530-3157
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Country | US
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Telephone | 510-232-5813
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Fax | 510-232-5813
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Provider Business Mailing Address
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Address Line | 1502 LAUREL AVE
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City | RICHMOND
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State | CA
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Zip | 94805-1622
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Country | US
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Telephone | 510-233-5261
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Fax | 510-232-5813
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC28123
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License Number State | CA
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