Provider Demographics
NPI:1033809876
Name:ALBERT, IAN DAVID (LMFT)
Entity Type:Individual
Prefix:
First Name:IAN
Middle Name:DAVID
Last Name:ALBERT
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 5TH ST STE 309
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-1542
Mailing Address - Country:US
Mailing Address - Phone:650-266-7581
Mailing Address - Fax:
Practice Address - Street 1:650 5TH ST STE 309
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-1542
Practice Address - Country:US
Practice Address - Phone:650-266-7581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36733106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist