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General NPI Number Information
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NPI Number | 1760358360
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Entity Type | Organization
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Legal Business Name | ANNALISE OPHELIAN PSYCHOLOGY INC.
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Dates
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Enumeration Date | 10/13/2025
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 463 DUBOCE AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94117-3541
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Country | US
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Telephone | 415-598-3092
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Fax | 415-236-3010
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Provider Business Mailing Address
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Address Line | 463 DUBOCE AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94117-3541
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Country | US
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Telephone | 415-598-3092
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Fax | 415-236-3010
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ANNALISE OPHELIAN
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Credential | PSYD
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Telephone | 415-845-3434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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