Provider Demographics
NPI:1487907119
Name:TURETSKY, LISA ANN (MA, LMFT)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:ANN
Last Name:TURETSKY
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 SAN PABLO AVE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-2277
Mailing Address - Country:US
Mailing Address - Phone:510-277-0455
Mailing Address - Fax:
Practice Address - Street 1:1035 SAN PABLO AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-2277
Practice Address - Country:US
Practice Address - Phone:510-277-0455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2014-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT84130106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist