=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093224545
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MS. MICHAELA LEARNE NACHT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/27/2017
-----------------------------------------------------
Last Update Date | 02/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 368 FELL ST
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94102-5144
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-861-0828
-----------------------------------------------------
Fax | 415-861-0257
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3328 SANTA CLARA AVE APT 2
-----------------------------------------------------
City | EL CERRITO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94530-3842
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-865-6730
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------