Provider Demographics
NPI:1275865040
Name:ESPINOZA LAU, SILVANA (LMFT)
Entity Type:Individual
Prefix:
First Name:SILVANA
Middle Name:
Last Name:ESPINOZA LAU
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:SILVANA
Other - Middle Name:
Other - Last Name:ESPINOZA SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4842 SW ASTER ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-1364
Mailing Address - Country:US
Mailing Address - Phone:541-204-6545
Mailing Address - Fax:
Practice Address - Street 1:302 NE PLYMOUTH CIR
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-4126
Practice Address - Country:US
Practice Address - Phone:541-204-6545
Practice Address - Fax:541-250-4402
Is Sole Proprietor?:No
Enumeration Date:2010-02-04
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ORT1601106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health