Provider Demographics
NPI:1366752685
Name:FERBER, LAWRENCE M (PHD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:M
Last Name:FERBER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1430 GORDON ST
Mailing Address - Street 2:UNIT F
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94061-2769
Mailing Address - Country:US
Mailing Address - Phone:650-533-2775
Mailing Address - Fax:650-817-9074
Practice Address - Street 1:300 HARBOR BLVD
Practice Address - Street 2:BUILDING E
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-4018
Practice Address - Country:US
Practice Address - Phone:650-817-9070
Practice Address - Fax:650-817-9074
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2014-09-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY018460-1103TC0700X
CAPSY23261103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)