Provider Demographics
NPI:1457785842
Name:HIMELSTEIN, LISA K (MS, LMFT)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:K
Last Name:HIMELSTEIN
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2406 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1817
Mailing Address - Country:US
Mailing Address - Phone:415-742-8112
Mailing Address - Fax:
Practice Address - Street 1:2406 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-1817
Practice Address - Country:US
Practice Address - Phone:415-742-8112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC50202106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist