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General NPI Number Information
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NPI Number | 1386159366
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Entity Type | Organization
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Legal Business Name | LORENZO TEIXEIRA, LPCC
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Dates
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Enumeration Date | 12/12/2017
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Last Update Date | 06/02/2018
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Provider Practice Location Address
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Address Line | 919 VILLAGE CTR STE 4
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City | LAFAYETTE
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State | CA
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Zip | 94549
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Country | US
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Telephone | 925-403-1349
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Fax |
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Provider Business Mailing Address
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Address Line | 32 ROBERT RD
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City | ORINDA
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State | CA
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Zip | 94563-3216
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHILD THERAPIST
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Name | LORENZO TEIXEIRA
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Credential | LPCC, RPT, NCC
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Telephone | 925-403-1349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3812
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License Number State | CA
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