Healthcare Provider Details

I. General information

NPI: 1710210992
Provider Name (Legal Business Name): ABRAHAM GUENTHER MFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2009
Last Update Date: 09/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 EDMONDS ROAD
REDWOOD CITY CA
94062
US

IV. Provider business mailing address

PO BOX 144
REDWOOD CITY CA
94064-0144
US

V. Phone/Fax

Practice location:
  • Phone: 650-367-1890
  • Fax:
Mailing address:
  • Phone: 415-571-5774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number51856
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: