Provider Demographics
NPI:1487981494
Name:LICHTI, DAVID CHRIS (LMFT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:CHRIS
Last Name:LICHTI
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 1:11573 LOS OSOS VALLEY RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-6473
Mailing Address - Country:US
Mailing Address - Phone:805-602-6814
Mailing Address - Fax:
Practice Address - Street 1:11573 LOS OSOS VALLEY RD
Practice Address - Street 2:SUITE H
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-6473
Practice Address - Country:US
Practice Address - Phone:805-602-6814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 45993106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist