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General NPI Number Information
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NPI Number | 1710495841
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Entity Type | Organization
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Legal Business Name | CARY ANN ROSKO, A MARRIAGE AND FAMILY THERAPY CORPORATION
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Dates
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Enumeration Date | 01/10/2018
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Last Update Date | 11/05/2021
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Provider Practice Location Address
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Address Line | 3884 24TH ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-3839
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Country | US
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Telephone | 415-689-8591
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Fax |
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Provider Business Mailing Address
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Address Line | 2443 FILLMORE ST # 38017539
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-1814
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Country | US
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Telephone | 415-689-8591
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Fax |
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | CARY ANN ROSKO
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Credential | LMFT
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Telephone | 415-689-8591
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 96606
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License Number State | CA
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