Provider Demographics
NPI:1154588523
Name:STEFFORA, THOMAS (LMFT)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:STEFFORA
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 MISTY GLEN PL
Mailing Address - Street 2:
Mailing Address - City:NIPOMO
Mailing Address - State:CA
Mailing Address - Zip Code:93444-5746
Mailing Address - Country:US
Mailing Address - Phone:805-929-6908
Mailing Address - Fax:805-929-6909
Practice Address - Street 1:301 S MILLER ST
Practice Address - Street 2:SUITE 112
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5205
Practice Address - Country:US
Practice Address - Phone:805-310-1878
Practice Address - Fax:805-929-6909
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88567106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist