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General NPI Number Information
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NPI Number | 1356489967
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Entity Type | Individual
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Provider Name | RICHARD DAVID COLEMAN MFT
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Gender | Male
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Dates
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Enumeration Date | 02/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3301 E 12TH ST SUITE 259
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City | OAKLAND
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State | CA
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Zip | 94601-3424
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Country | US
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Telephone | 510-269-9046
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Fax |
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Provider Business Mailing Address
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Address Line | 2314 DERBY ST
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City | BERKELEY
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State | CA
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Zip | 94705-1105
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Country | US
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Telephone | 510-540-8217
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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 | MFC19962
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License Number State | CA
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