Provider Demographics
NPI:1336410034
Name:ALBANO, JUDITH LUCIA IGNACIO (LMFT)
Entity Type:Individual
Prefix:
First Name:JUDITH LUCIA
Middle Name:IGNACIO
Last Name:ALBANO
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 1:80 EUREKA SQ STE 215
Mailing Address - Street 2:
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-2677
Mailing Address - Country:US
Mailing Address - Phone:415-269-5254
Mailing Address - Fax:415-480-1444
Practice Address - Street 1:80 EUREKA SQ STE 215
Practice Address - Street 2:
Practice Address - City:PACIFICA
Practice Address - State:CA
Practice Address - Zip Code:94044-2677
Practice Address - Country:US
Practice Address - Phone:415-269-5254
Practice Address - Fax:415-480-1444
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-26
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105832106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist