Provider Demographics
NPI:1861895021
Name:SCIUTTO, L ALLEN (LMFT)
Entity type:Individual
Prefix:
First Name:L
Middle Name:ALLEN
Last Name:SCIUTTO
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:LAWRENCE
Other - Middle Name:ALLEN
Other - Last Name:SCIUTTO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 20126
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94309-0126
Mailing Address - Country:US
Mailing Address - Phone:650-223-5607
Mailing Address - Fax:
Practice Address - Street 1:164 MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-2905
Practice Address - Country:US
Practice Address - Phone:650-223-5607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53929106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist