Healthcare Provider Details

I. General information

NPI: 1295128486
Provider Name (Legal Business Name): ARIN BASS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ARIN BASS LASOFF LMFT

II. Dates (important events)

Enumeration Date: 03/11/2015
Last Update Date: 03/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 CALIFORNIA ST
SAN FRANCISCO CA
94115-2464
US

IV. Provider business mailing address

449 35TH AVE
SAN FRANCISCO CA
94121-1609
US

V. Phone/Fax

Practice location:
  • Phone: 216-536-8873
  • Fax:
Mailing address:
  • Phone: 216-536-8873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number83366
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: