Healthcare Provider Details

I. General information

NPI: 1801218946
Provider Name (Legal Business Name): ALTHEA MARIE YAP MA, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2014
Last Update Date: 05/19/2023
Certification Date: 05/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3626 BALBOA ST
SAN FRANCISCO CA
94121-2604
US

IV. Provider business mailing address

3626 BALBOA ST
SAN FRANCISCO CA
94121-2604
US

V. Phone/Fax

Practice location:
  • Phone: 415-668-5955
  • Fax:
Mailing address:
  • Phone: 415-223-2464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number110129
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number135005
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: