Provider Demographics
NPI:1467664011
Name:LORI GOLDRICH AND STEVEN HERRMANN, A PSYCHOTHERAPY CORPORATION
Entity Type:Organization
Organization Name:LORI GOLDRICH AND STEVEN HERRMANN, A PSYCHOTHERAPY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGISTPRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDRICH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:510-531-2534
Mailing Address - Street 1:56 WEYBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-2750
Mailing Address - Country:US
Mailing Address - Phone:510-531-2534
Mailing Address - Fax:
Practice Address - Street 1:56 WEYBRIDGE CT
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-2750
Practice Address - Country:US
Practice Address - Phone:510-531-2534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13691103TC0700X
CAMFT24464106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALICENSEOtherMARRIAGE FAMILY COUNSELOR
CAPSY13691OtherLICENSE