Provider Demographics
NPI:1780878819
Name:BUENO, LIDIA CRISTINA (PHD, LMFT)
Entity type:Individual
Prefix:DR
First Name:LIDIA
Middle Name:CRISTINA
Last Name:BUENO
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:LIDIA
Other - Middle Name:
Other - Last Name:DE LEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 28201
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95159-8201
Mailing Address - Country:US
Mailing Address - Phone:408-596-6862
Mailing Address - Fax:
Practice Address - Street 1:586 N 1ST ST STE 228
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-5365
Practice Address - Country:US
Practice Address - Phone:408-596-6862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54049106H00000X
CA50042106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist