Healthcare Provider Details

I. General information

NPI: 1912654583
Provider Name (Legal Business Name): CALLISTA RUTH COX AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2022
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2354 POST ST
SAN FRANCISCO CA
94115-3424
US

IV. Provider business mailing address

2354 POST ST
SAN FRANCISCO CA
94115-3424
US

V. Phone/Fax

Practice location:
  • Phone: 619-609-0180
  • Fax: 619-730-4469
Mailing address:
  • Phone: 619-609-0180
  • Fax: 619-730-4469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number141253
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: