Provider Demographics
NPI:1912667213
Name:WARD, LA VIOLA (LPCC)
Entity Type:Individual
Prefix:
First Name:LA VIOLA
Middle Name:
Last Name:WARD
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 1:9837 FOLSOM BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-1356
Mailing Address - Country:US
Mailing Address - Phone:916-450-2600
Mailing Address - Fax:
Practice Address - Street 1:9837 FOLSOM BLVD STE F
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-1356
Practice Address - Country:US
Practice Address - Phone:916-450-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16405101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional