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General NPI Number Information
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NPI Number | 1346699691
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Entity Type | Organization
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Legal Business Name | GRATEFUL HEART HOLISTIC THERAPY CENTER
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Dates
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Enumeration Date | 06/07/2016
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Last Update Date | 06/07/2016
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Provider Practice Location Address
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Address Line | 2120 MARKET ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-1376
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Country | US
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Telephone | 415-553-5346
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Fax |
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Provider Business Mailing Address
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Address Line | 360 GRAND AVE #46
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City | OAKLAND
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State | CA
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Zip | 94610-4840
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | RAWNA ROMERO
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Credential |
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Telephone | 415-553-9724
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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 | INTERN 82129
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License Number State | CA
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