Provider Demographics
NPI:1437230430
Name:LEGALLET, STEVE J. (MFT)
Entity Type:Individual
Prefix:MR
First Name:STEVE J.
Middle Name:
Last Name:LEGALLET
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 BAY AVE
Mailing Address - Street 2:208-D
Mailing Address - City:CAPITOLA
Mailing Address - State:CA
Mailing Address - Zip Code:95010-2140
Mailing Address - Country:US
Mailing Address - Phone:831-476-4045
Mailing Address - Fax:
Practice Address - Street 1:820 BAY AVE
Practice Address - Street 2:208-D
Practice Address - City:CAPITOLA
Practice Address - State:CA
Practice Address - Zip Code:95010-2140
Practice Address - Country:US
Practice Address - Phone:831-476-4045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC29121106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist