Provider Demographics
NPI:1558564070
Name:STIEFVATER, VICTORIA A (LMFT)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:A
Last Name:STIEFVATER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:A
Other - Last Name:STIEFVATER-ROFFERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-0157
Mailing Address - Country:US
Mailing Address - Phone:510-486-8299
Mailing Address - Fax:925-385-7154
Practice Address - Street 1:2421 4TH ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710
Practice Address - Country:US
Practice Address - Phone:510-486-8299
Practice Address - Fax:510-595-7854
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2018-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT32420106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist