Provider Demographics
NPI:1962672766
Name:PINA, LORI MACCHI (MS LMFT)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:MACCHI
Last Name:PINA
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:MS
Other - First Name:LORI
Other - Middle Name:ANNE
Other - Last Name:MACCHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1350 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-3008
Mailing Address - Country:US
Mailing Address - Phone:650-346-4455
Mailing Address - Fax:
Practice Address - Street 1:1350 CHERRY ST
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-3008
Practice Address - Country:US
Practice Address - Phone:650-346-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA89384106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1962672766OtherKAISER