Provider Demographics
NPI:1952822991
Name:MOSBY, VIRGINIA RUTLEDGE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:RUTLEDGE
Last Name:MOSBY
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 1:3180 CROW CANYON PL STE 140
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1339
Mailing Address - Country:US
Mailing Address - Phone:925-820-1467
Mailing Address - Fax:925-855-1366
Practice Address - Street 1:3180 CROW CANYON PLACE #140
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583
Practice Address - Country:US
Practice Address - Phone:925-820-1467
Practice Address - Fax:925-855-1366
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43184106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist