Healthcare Provider Details

I. General information

NPI: 1043852213
Provider Name (Legal Business Name): CARLA PAULI-GISMONDI AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2019
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 EXECUTIVE PARK BLVD STE 4900
SAN FRANCISCO CA
94134-3335
US

IV. Provider business mailing address

PO BOX 475295
SAN FRANCISCO CA
94147-5295
US

V. Phone/Fax

Practice location:
  • Phone: 415-656-0116
  • Fax:
Mailing address:
  • Phone: 650-906-3857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number115528
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: