Provider Demographics
NPI:1588339261
Name:SIZEMORE, ANN CATHERINE (MFT)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:CATHERINE
Last Name:SIZEMORE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 N THOMPSON RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-3143
Mailing Address - Country:US
Mailing Address - Phone:510-913-0419
Mailing Address - Fax:
Practice Address - Street 1:1109 N THOMPSON RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-3143
Practice Address - Country:US
Practice Address - Phone:510-913-0419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC53958106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty