MEDICARE: DR. VITTORIO COMELLI PSYD

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	103TH0004X	Health Psychologist
2	103TH0100X	Health Service Psychologist
3	103TP2701X	Group Psychotherapy Psychologist
4	103TC0700X	Clinical Psychologist	PSY 21880	CA

General Provider Information

NPI Number	:	1881865194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VITTORIO COMELLI PSYD

Provider Business Mailing Address
First Line	:	582 MARKET ST STE 714
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94104-5308
Country	:	US
Telephone Number	:	415-919-9803
Fax Number	:

Provider Business Practice Location Address
First Line	:	582 MARKET ST STE 714
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94104-5308
Country	:	US
Telephone Number	:	415-919-9803
Fax Number	:

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

Provider Enumeration Date	:	03/13/2008
Last Update Date	:	03/01/2024

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