MEDICARE: MS. SELENE L HONG MFT

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	MFC 44498	CA

General Provider Information

NPI Number	:	1437280047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SELENE L HONG MFT

Provider Business Mailing Address
First Line	:	1115 TAYLOR ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94108-1950
Country	:	US
Telephone Number	:	415-202-9770
Fax Number	:

Provider Business Practice Location Address
First Line	:	1426 FILLMORE ST
Second Line	:	STE 303
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-5236
Country	:	US
Telephone Number	:	415-202-9770
Fax Number	:

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

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	09/08/2009

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