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NPI 1689074494

NPI 1689074494 : LYDIA STEVENS MA, MFT : SAN FRANCISCO, CA

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General NPI Number Information
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    NPI Number           |    1689074494
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    Entity Type          |    Individual 
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    Provider Name        |    LYDIA STEVENS MA, MFT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/28/2014
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    Last Update Date     |    03/17/2018
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Provider Practice Location Address
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    Address Line         |    1829 MARKET ST STE 207 
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    City                 |    SAN FRANCISCO
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    State                |    CA
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    Zip                  |    94103-7414
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    Country              |    US
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    Telephone            |    415-991-0575
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1801 TURK ST APT 7 
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    City                 |    SAN FRANCISCO
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    State                |    CA
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    Zip                  |    94115-4430
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    Country              |    US
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    Telephone            |    415-852-2052
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    Fax                  |    
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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       |    75619
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    License Number State |    CA
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Taxonomy #2
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    Taxonomy Code        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    93416
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    License Number State |    CA
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