Provider Demographics
NPI:1710138342
Name:LASSEGARD, SHEILA ANN (LMFT)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:ANN
Last Name:LASSEGARD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-9366
Mailing Address - Country:US
Mailing Address - Phone:805-462-4672
Mailing Address - Fax:805-462-3496
Practice Address - Street 1:200 S MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-9366
Practice Address - Country:US
Practice Address - Phone:805-462-4672
Practice Address - Fax:805-462-3496
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35967106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist