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NPI Code Detail

MEDICARE: ROBERT WILEY MFT

MEDICARE:   ROBERT  WILEY  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 TherapistMFC39456CA

General Provider Information

NPI Number : 1871665877
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT WILEY MFT
Provider Business Mailing Address
First Line : 1190 VALLEJO ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94109-2119
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 134 GOLDEN GATE AVE
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94102-3810
Country : US
Telephone Number : 415-673-5700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2006
Last Update Date : 04/09/2012

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Directions to “ ROBERT WILEY MFT” Practice Location

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