Provider Demographics
NPI:1003262478
Name:LO GIUDICE, PABLO HERNAN (MA)
Entity Type:Individual
Prefix:MR
First Name:PABLO
Middle Name:HERNAN
Last Name:LO GIUDICE
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 VAN NESS AVE STE E3-429
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-3200
Mailing Address - Country:US
Mailing Address - Phone:915-400-1212
Mailing Address - Fax:
Practice Address - Street 1:101 GROVE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-4593
Practice Address - Country:US
Practice Address - Phone:159-400-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC6986101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional