Healthcare Provider Details

I. General information

NPI: 1801956784
Provider Name (Legal Business Name): MARC A RAPPAPORT LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 01/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 GOUGH ST
SAN FRANCISCO CA
94102-5903
US

IV. Provider business mailing address

584 CASTRO ST # 308
SAN FRANCISCO CA
94114-2512
US

V. Phone/Fax

Practice location:
  • Phone: 415-503-3137
  • Fax: 415-864-2086
Mailing address:
  • Phone: 415-820-9640
  • Fax: 415-865-9994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC44839
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: