Provider Demographics
NPI:1316345762
Name:ROHRER, VICTORIA (LMFT)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:
Last Name:ROHRER
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 1:36 WOODWORTH LN
Mailing Address - Street 2:
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-7634
Mailing Address - Country:US
Mailing Address - Phone:707-494-1279
Mailing Address - Fax:
Practice Address - Street 1:814 BROADWAY
Practice Address - Street 2:
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-7013
Practice Address - Country:US
Practice Address - Phone:707-509-8031
Practice Address - Fax:707-339-8339
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-17
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF81580106H00000X
CA110700106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1222242Medicaid