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NPI 1245663954

NPI 1245663954 : MICHAEL J LOEFFLER JR. MFT# 53839 : SAN FRANCISCO, CA

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General NPI Number Information
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    NPI Number           |    1245663954
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    Entity Type          |    Individual 
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    Provider Name        |    MICHAEL J LOEFFLER JR. MFT# 53839
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/16/2013
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    Last Update Date     |    08/16/2013
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Provider Practice Location Address
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    Address Line         |    211 GOUGH ST STE 111 SAN FRANCISCO, CA 94102
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    City                 |    SAN FRANCISCO
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    State                |    CA
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    Zip                  |    94102-6802
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    Country              |    US
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    Telephone            |    415-938-7920
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    211 GOUGH, SUITE 111 SAN FRANCISCO, CA 94102
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    City                 |    SAN FRANCISCO
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    State                |    CA
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    Zip                  |    94117
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    Country              |    US
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    Telephone            |    415-938-7920
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    53839
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    License Number State |    CA
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