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General NPI Number Information
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NPI Number | 1952666810
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Entity Type | Individual
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Provider Name | BRUCE HEARN M.A., LMFT
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Gender | Male
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Dates
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Enumeration Date | 07/06/2012
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Last Update Date | 06/10/2022
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Provider Practice Location Address
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Address Line | 220 MONTGOMERY ST SUITE 317
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City | SAN FRANCISCO
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State | CA
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Zip | 94104-3402
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Country | US
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Telephone | 415-598-8956
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 401101
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City | SAN FRANCISCO
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State | CA
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Zip | 94140-1101
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Country | US
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Telephone | 415-598-8956
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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 | MFT-79269
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License Number State | CA
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