Facts
- Status
- A
- Credential
- LMFT
- Type
- Individual
- Enumeration date
- 2016-08-16
- Last updated
- 2019-10-07
Specialties
Licenses
- License CA
- LMFT93814
Location
- Practice location
- 2340 WARD ST
- City
- BERKELEY CA
- Postal code
- 947051124
- Phone
- 510-560-4492
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.