MEDICARE: CALEB PETER BIRKHOFF

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	101YM0800X	Mental Health Counselor
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	106H00000X	Marriage & Family Therapist	93501	CA

General Provider Information

NPI Number	:	1417396615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CALEB PETER BIRKHOFF

Provider Business Mailing Address
First Line	:	2021 FILLMORE ST # 2148
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-2708
Country	:	US
Telephone Number	:	415-742-2225
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 UNION ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94123-4406
Country	:	US
Telephone Number	:	415-742-2225
Fax Number	:

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

Provider Enumeration Date	:	06/20/2013
Last Update Date	:	06/02/2026

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