Provider Demographics
NPI:1811604390
Name:LALANNE, JACQUELINE (AMFT 127563)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:LALANNE
Suffix:
Gender:F
Credentials:AMFT 127563
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2490 GREENWICH ST APT 201
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-3393
Mailing Address - Country:US
Mailing Address - Phone:415-828-3154
Mailing Address - Fax:
Practice Address - Street 1:3329 SACRAMENTO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1911
Practice Address - Country:US
Practice Address - Phone:415-735-4318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist