Healthcare Provider Details

I. General information

NPI: 1487422432
Provider Name (Legal Business Name): THERAPY IN DEPTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2023
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2858 DIAMOND ST
SAN FRANCISCO CA
94131-3055
US

IV. Provider business mailing address

4083 24TH ST STE 304
SAN FRANCISCO CA
94114-3715
US

V. Phone/Fax

Practice location:
  • Phone: 415-494-9823
  • Fax:
Mailing address:
  • Phone: 415-494-9823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. BERNARD FITZPATRICK
Title or Position: PRESIDENT
Credential: PHD
Phone: 415-494-9823