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1730 Divisadero St Ste 1 San Francisco CA 94115-3012 | |
| (510) 282-4137 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1730 Divisadero St Ste 1, San Francisco, California |
| Authorized Official Name and Position | Knute Johnson (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 5102824137 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1730 Divisadero St Ste 1 San Francisco CA 94115-3012 Ph: (510) 282-4137 | 1730 Divisadero St Ste 1 San Francisco CA 94115-3012 Ph: (510) 282-4137 |
| NPI Number | 1740687888 |
|---|---|
| Provider Enumeration Date | 12/03/2014 |
| Last Update Date | 12/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740687888 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 26111 (California) | Primary |
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