Provider Demographics
NPI:1770768772
Name:SIAMAS, ELIZABETH ANN
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:SIAMAS
Suffix:
Gender:
Credentials:
Other - Prefix:MRS
Other - First Name:LYSA
Other - Middle Name:ANN
Other - Last Name:SIAMAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6317 LAURA LN
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-9710
Mailing Address - Country:US
Mailing Address - Phone:925-989-0330
Mailing Address - Fax:
Practice Address - Street 1:6317 LAURA LN
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-9710
Practice Address - Country:US
Practice Address - Phone:925-989-0330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA52433106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health