Provider Demographics
NPI:1003514704
Name:KOERNER, LIFAN WANG (AMFT)
Entity Type:Individual
Prefix:MRS
First Name:LIFAN
Middle Name:WANG
Last Name:KOERNER
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:MRS
Other - First Name:LYDIA
Other - Middle Name:WANG
Other - Last Name:KOERNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AMFT
Mailing Address - Street 1:986 MORAGA RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-4423
Mailing Address - Country:US
Mailing Address - Phone:925-954-6229
Mailing Address - Fax:925-269-8052
Practice Address - Street 1:986 MORAGA RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4423
Practice Address - Country:US
Practice Address - Phone:925-954-6229
Practice Address - Fax:925-269-8052
Is Sole Proprietor?:No
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist