Healthcare Provider Details

I. General information

NPI: 1770739518
Provider Name (Legal Business Name): MICHAEL SCHIMEK
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2008
Last Update Date: 08/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2675 FOLSOM ST
SAN FRANCISCO CA
94110-3325
US

IV. Provider business mailing address

901 SCOTT ST
SAN FRANCISCO CA
94115-4522
US

V. Phone/Fax

Practice location:
  • Phone: 415-643-7117
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMFT INTERN # 53832
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: