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General NPI Number Information
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NPI Number | 1942668892
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Entity Type | Organization
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Legal Business Name | LEVIS THERAPY, A MARRIAGE AND FAMILY THERAPY CORPORATION
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Dates
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Enumeration Date | 02/07/2016
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Last Update Date | 02/07/2016
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Provider Practice Location Address
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Address Line | 1246 CASTRO ST APT 2
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-3265
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Country | US
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Telephone | 415-683-1008
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 318003
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City | SAN FRANCISCO
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State | CA
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Zip | 94131-8003
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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 | PRESIDENT
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Name | RAJANI VENKATRAMAN LEVIS
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Credential |
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Telephone | 415-683-1008
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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 | MFT 51494
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License Number State | CA
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