Provider Demographics
NPI:1801351556
Name:SOBALVARRO, ANA ISABEL (LPCC)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:ISABEL
Last Name:SOBALVARRO
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93423-0003
Mailing Address - Country:US
Mailing Address - Phone:805-470-9188
Mailing Address - Fax:
Practice Address - Street 1:9025 COROMAR CT
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-6130
Practice Address - Country:US
Practice Address - Phone:805-550-9553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-06
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC11084101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health