Provider Demographics
NPI:1497159180
Name:TEIXEIRA, LORENZO (LPCC)
Entity Type:Individual
Prefix:
First Name:LORENZO
Middle Name:
Last Name:TEIXEIRA
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 MORAGA RD STE D
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-4567
Mailing Address - Country:US
Mailing Address - Phone:925-403-1349
Mailing Address - Fax:925-298-5946
Practice Address - Street 1:901 MORAGA RD STE D
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4567
Practice Address - Country:US
Practice Address - Phone:925-403-1349
Practice Address - Fax:925-298-5946
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-09
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3812101YM0800X, 101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional