Healthcare Provider Details

I. General information

NPI: 1144983586
Provider Name (Legal Business Name): JAHI CORBIN AMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2021
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 CALIFORNIA ST STE 1500
SAN FRANCISCO CA
94111-4612
US

IV. Provider business mailing address

50 CALIFORNIA ST STE 1500
SAN FRANCISCO CA
94111-4612
US

V. Phone/Fax

Practice location:
  • Phone: 415-854-5400
  • Fax:
Mailing address:
  • Phone: 415-854-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number16068
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number149445
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: