MEDICARE: CARLY KONTRA

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		CA

General Provider Information

NPI Number	:	1659223683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLY KONTRA

Provider Business Mailing Address
First Line	:	1197 VALENCIA ST # 5
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-3026
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1197 VALENCIA ST # 5
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-3026
Country	:	US
Telephone Number	:	415-496-5556
Fax Number	:

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

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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Directions to “ CARLY KONTRA ” Practice Location

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