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General NPI Number Information
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NPI Number | 1982679718
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Entity Type | Individual
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Provider Name | KARINA SUZANNE VON MIDDENDORF LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 1 MARKET ST FL 36
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City | SAN FRANCISCO
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State | CA
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Zip | 94105-1420
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Country | US
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Telephone | 415-408-8801
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Fax | 866-849-0672
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Provider Business Mailing Address
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Address Line | 1083 VINE ST STE 740
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City | HEALDSBURG
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State | CA
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Zip | 95448-4830
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Country | US
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Telephone | 415-408-8801
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Fax | 866-849-0672
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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 | 38189
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License Number State | CA
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