Healthcare Provider Details

I. General information

NPI: 1306618764
Provider Name (Legal Business Name): STEPHEN JACOB COFFEY LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2023
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 14494
SAN FRANCISCO CA
94114-0494
US

IV. Provider business mailing address

4304 18TH ST
SAN FRANCISCO CA
94114-9004
US

V. Phone/Fax

Practice location:
  • Phone: 415-326-8414
  • Fax:
Mailing address:
  • Phone: 415-326-8414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number164076
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: