Provider Demographics
NPI:1467776187
Name:NAVE, LISA M (MFT)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:M
Last Name:NAVE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 SHELL RD
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-1551
Mailing Address - Country:US
Mailing Address - Phone:415-272-4472
Mailing Address - Fax:415-388-5573
Practice Address - Street 1:902 CURTIS ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-2108
Practice Address - Country:US
Practice Address - Phone:415-272-4472
Practice Address - Fax:415-388-5573
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35617106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist