MEDICARE: DR. TODD B RISING PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	103TC0700X	Clinical Psychologist	PSY30763	CA

General Provider Information

NPI Number	:	1497911747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TODD B RISING PSY.D.

Provider Business Mailing Address
First Line	:	45 FRANKLIN ST STE 304
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-6047
Country	:	US
Telephone Number	:	415-484-8627
Fax Number	:

Provider Business Practice Location Address
First Line	:	45 FRANKLIN ST STE 304
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-6047
Country	:	US
Telephone Number	:	415-484-8627
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2008
Last Update Date	:	04/26/2019

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