Provider Demographics
NPI:1265842108
Name:THOMAS STEIN, PSYCHOTHERAPIST
Entity Type:Organization
Organization Name:THOMAS STEIN, PSYCHOTHERAPIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:805-881-3136
Mailing Address - Street 1:700 MAR VISTA DR
Mailing Address - Street 2:
Mailing Address - City:LOS OSOS
Mailing Address - State:CA
Mailing Address - Zip Code:93402-3812
Mailing Address - Country:US
Mailing Address - Phone:805-881-3136
Mailing Address - Fax:
Practice Address - Street 1:1190 MARSH ST STE F
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-3332
Practice Address - Country:US
Practice Address - Phone:805-881-3136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC48767106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty