Healthcare Provider Details

I. General information

NPI: 1770195679
Provider Name (Legal Business Name): ADAM BROWN LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2020
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 GENERAL KENNEDY AVENUE FLOOR 1
SAN FRANCISCO CA
94129
US

IV. Provider business mailing address

1008 GENERAL KENNEDY AVENUE FLOOR 1
SAN FRANCISCO CA
94129
US

V. Phone/Fax

Practice location:
  • Phone: 415-295-2015
  • Fax:
Mailing address:
  • Phone: 415-295-2015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number146387
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: