Provider Demographics
NPI:1033257357
Name:LORBER, MARTIN STEVE (PHD)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:STEVE
Last Name:LORBER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:LORBER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:1009 W CLAY ST
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-4604
Mailing Address - Country:US
Mailing Address - Phone:707-367-7930
Mailing Address - Fax:
Practice Address - Street 1:1009 W CLAY ST
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-4604
Practice Address - Country:US
Practice Address - Phone:707-367-7930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 12360103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist