Provider Demographics
NPI:1710498977
Name:LEVAGGI, LORI (LMFT)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:LEVAGGI
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 1:766 SANTA YNEZ ST
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-8441
Mailing Address - Country:US
Mailing Address - Phone:650-326-5141
Mailing Address - Fax:
Practice Address - Street 1:768 SANTA YNEZ ST
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-8441
Practice Address - Country:US
Practice Address - Phone:650-326-5141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27321106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist