Kristen E Fong MFT

NPI 1790955516 - Preferred Provider Organization - 305R00000X

NPI Details
NPI 1790955516
Gender Female
Enumeration Date 03/07/2008
Last Updated 07/20/2015
Entity Type Individual
Active Over 8 years ago
Practice Location
1050 NORTHGATE DR
SUITE 12
SAN RAFAEL CA, 94903-2526, US
Phone (415) 250-0541
Fax
Business Location
1050 NORTHGATE DR
SUITE 12
SAN RAFAEL CA, 94903-2526, US
Phone (415) 250-0541
Fax
Toxanomy
Taxonomy Code 305R00000X
License State California
License Number MFC36228
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According to our database, Kristen E Fong MFT NPI is 1790955516, taxonomy code is 305R00000X and license number is MFC36228, license state is located at California. Kristen E Fong MFT physically located at 1050 Northgate Dr, San Rafael CA, 94903-2526. NPI Number Kristen E Fong MFT has the Individual type.

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1790955516 NPI number is provided on an as is basis without warranty of any kind. 1790955516 is maintained by the National Plan & Provider Enumeration System. The contents of Kristen E Fong MFT are for informational purposes only.