Provider Demographics
NPI:1073640314
Name:LECHNER, JASON (LMFT 51079)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:LECHNER
Suffix:
Gender:M
Credentials:LMFT 51079
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 SKILLMAN LN
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-1250
Mailing Address - Country:US
Mailing Address - Phone:925-324-8089
Mailing Address - Fax:
Practice Address - Street 1:1733 SKILLMAN LN
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-1250
Practice Address - Country:US
Practice Address - Phone:925-324-8089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51079106H00000X
CAMFT INTERN 58470101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist