Healthcare Provider Details

I. General information

NPI: 1497820450
Provider Name (Legal Business Name): LINDA KLANN MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 COLUMBUS AVE
SAN FRANCISCO CA
94133-1303
US

IV. Provider business mailing address

665 EDDY ST APT. 44
SAN FRANCISCO CA
94109-7946
US

V. Phone/Fax

Practice location:
  • Phone: 415-596-1845
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number42170
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: