Provider Demographics
NPI:1750562633
Name:COMPAGNONI, LAWRENCE (MA, LMFT)
Entity type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:
Last Name:COMPAGNONI
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1061 EL MONTE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-2336
Mailing Address - Country:US
Mailing Address - Phone:650-964-9396
Mailing Address - Fax:408-736-9354
Practice Address - Street 1:1061 EL MONTE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-2336
Practice Address - Country:US
Practice Address - Phone:650-964-9396
Practice Address - Fax:408-736-9354
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC15191106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist