Provider Demographics
NPI:1710496468
Name:LAPASTORA, MARIANNE KATARIINA (PSYD)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:KATARIINA
Last Name:LAPASTORA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21701 STEVENS CREEK BLVD # 2914
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-1119
Mailing Address - Country:US
Mailing Address - Phone:540-270-8649
Mailing Address - Fax:
Practice Address - Street 1:21701 STEVENS CREEK BLVD UNIT 2914
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95015-3418
Practice Address - Country:US
Practice Address - Phone:540-270-8649
Practice Address - Fax:540-270-8649
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-26
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4315103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool