Healthcare Provider Details

I. General information

NPI: 1134639388
Provider Name (Legal Business Name): THERESA C. KIRA, PSYD, A PSYCHOLOGICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2017
Last Update Date: 02/08/2020
Certification Date: 02/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 MARKET ST STE 800
SAN FRANCISCO CA
94102-2903
US

IV. Provider business mailing address

870 MARKET ST STE 800
SAN FRANCISCO CA
94102-2903
US

V. Phone/Fax

Practice location:
  • Phone: 415-417-1847
  • Fax:
Mailing address:
  • Phone: 415-417-1847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. THERESA C KIRA
Title or Position: OWNER
Credential: PSYD
Phone: 415-417-1847