Provider Demographics
NPI:1902288186
Name:LIEBERT, JEFFREY (MA, LMFT)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:LIEBERT
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4766 ELMHURST DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-2027
Mailing Address - Country:US
Mailing Address - Phone:916-365-6078
Mailing Address - Fax:
Practice Address - Street 1:21710 STEVENS CREEK BLVD
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-1172
Practice Address - Country:US
Practice Address - Phone:916-365-6078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2018-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist