Healthcare Provider Details

I. General information

NPI: 1912230921
Provider Name (Legal Business Name): ERIN MULLIN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2009
Last Update Date: 09/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1939 DIVISADERO ST STE 4A
SAN FRANCISCO CA
94115-2507
US

IV. Provider business mailing address

1939 DIVISADERO ST STE 4A
SAN FRANCISCO CA
94115-2507
US

V. Phone/Fax

Practice location:
  • Phone: 415-931-8552
  • Fax:
Mailing address:
  • Phone: 415-931-8552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY14176
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License NumberPSY14176
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: