Provider Demographics
NPI:1699176453
Name:LEFEBVRE, MICHELLE ELAINE (PSYD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ELAINE
Last Name:LEFEBVRE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:ELAINE
Other - Last Name:BOBBETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:1560 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1023
Mailing Address - Country:US
Mailing Address - Phone:530-225-5200
Mailing Address - Fax:
Practice Address - Street 1:1560 MARKET ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1023
Practice Address - Country:US
Practice Address - Phone:530-225-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-11
Last Update Date:2023-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC2200X, 390200000X
CA31959103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program