Provider Demographics
NPI:1962689539
Name:VON FRAUSING-BORCH, OLE (LMFT)
Entity Type:Individual
Prefix:MR
First Name:OLE
Middle Name:
Last Name:VON FRAUSING-BORCH
Suffix:
Gender:M
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:PO BOX 6574
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93456-6574
Mailing Address - Country:US
Mailing Address - Phone:805-925-5470
Mailing Address - Fax:805-922-3263
Practice Address - Street 1:301 S MILLER ST STE 121
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5243
Practice Address - Country:US
Practice Address - Phone:805-925-5470
Practice Address - Fax:805-922-3263
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8963106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist