Provider Demographics
NPI:1538668744
Name:MUELLERLEILE, VANESSA (LMFT)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:MUELLERLEILE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:
Other - Last Name:VARRELMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3519
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-3519
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1811 SANTA RITA RD STE 220
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-4732
Practice Address - Country:US
Practice Address - Phone:925-494-1717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-03
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT97231101YM0800X, 106H00000X
101YS0200X
CA97231106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool