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General NPI Number Information
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NPI Number | 1639193733
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Entity Type | Individual
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Provider Name | SUZANNE D ALFANDARI MFT
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Gender | Female
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 03/02/2011
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Provider Practice Location Address
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Address Line | 3230 KERNER BLVD
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City | SAN RAFAEL
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State | CA
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Zip | 94901-4840
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Country | US
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Telephone | 415-473-7547
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 150605
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City | SAN RAFAEL
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State | CA
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Zip | 94915-0605
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Country | US
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Telephone | 415-456-2259
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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 | MFC36334
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License Number State | CA
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