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NPI Code Detail

MEDICARE: MR. DENNIS CORT THATCHER MFT

MEDICARE: MR. DENNIS CORT THATCHER 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
1106H00000XMarriage & Family TherapistMFT25186CA

General Provider Information

NPI Number : 1477578243
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DENNIS CORT THATCHER MFT
Provider Business Mailing Address
First Line : 2404 10TH ST
Second Line :
City : BERKELEY
State : CA
Zip : 94710-2506
Country : US
Telephone Number : 510-666-1158
Fax Number : 501-638-9293
Provider Business Practice Location Address
First Line : 944 IRVING ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94122-2207
Country : US
Telephone Number : 415-995-2916
Fax Number : 501-638-9293
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2006
Last Update Date : 07/08/2007

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Directions to “ MR. DENNIS CORT THATCHER MFT” Practice Location

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