Provider Demographics
NPI:1205433273
Name:TREJO, ANNA SOFIA (LMFT)
Entity type:Individual
Prefix:
First Name:ANNA SOFIA
Middle Name:
Last Name:TREJO
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 1:1070 S STELLING RD
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-5019
Mailing Address - Country:US
Mailing Address - Phone:408-964-8194
Mailing Address - Fax:
Practice Address - Street 1:4 MAIN ST STE 110
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-2931
Practice Address - Country:US
Practice Address - Phone:650-266-8273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44417106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist