Provider Demographics
NPI:1801431341
Name:STORR, VICTORIA RAE (LMFT)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:RAE
Last Name:STORR
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 1:447 SUTTER ST STE 429
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4630
Mailing Address - Country:US
Mailing Address - Phone:530-329-2400
Mailing Address - Fax:
Practice Address - Street 1:447 SUTTER ST.
Practice Address - Street 2:STE 429
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108
Practice Address - Country:US
Practice Address - Phone:530-329-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103TS0200X
CA111000106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool