Provider Demographics
NPI:1598941197
Name:PANZIERA, LOIS ROSEANNE (MFC 31855 CA PUPIL)
Entity Type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:ROSEANNE
Last Name:PANZIERA
Suffix:
Gender:F
Credentials:MFC 31855 CA PUPIL
Other - Prefix:MISS
Other - First Name:LOIS
Other - Middle Name:ROSEANNE
Other - Last Name:ANASTAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:199 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOLEDAD
Mailing Address - State:CA
Mailing Address - Zip Code:93960-3023
Mailing Address - Country:US
Mailing Address - Phone:831-678-4924
Mailing Address - Fax:
Practice Address - Street 1:199 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOLEDAD
Practice Address - State:CA
Practice Address - Zip Code:93960-3023
Practice Address - Country:US
Practice Address - Phone:831-678-4924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFC31855106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist