Healthcare Provider Details

I. General information

NPI: 1801703095
Provider Name (Legal Business Name): BAY AREA SOMATIC THERAPY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 ASHBURY ST APT 6
SAN FRANCISCO CA
94117-4466
US

IV. Provider business mailing address

816 ASHBURY ST APT 6
SAN FRANCISCO CA
94117-4466
US

V. Phone/Fax

Practice location:
  • Phone: 901-833-7935
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KAITLYN VINCENT
Title or Position: FOUNDER
Credential:
Phone: 901-833-7935