MEDICARE: IVAN BELYAEV

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	AMFT144021	CA

General Provider Information

NPI Number	:	1164291217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IVAN BELYAEV

Provider Business Mailing Address
First Line	:	530 DIVISADERO ST # 719
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94117-2213
Country	:	US
Telephone Number	:	415-723-5655
Fax Number	:

Provider Business Practice Location Address
First Line	:	530 DIVISADERO ST # 719
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94117-2213
Country	:	US
Telephone Number	:	415-723-5655
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2023
Last Update Date	:	08/05/2025

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Directions to “ IVAN BELYAEV ” Practice Location

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