Provider Demographics
NPI:1033870316
Name:KLINGENBERGER, EMILY ANN (AMFT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:KLINGENBERGER
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 GEARY BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-3380
Mailing Address - Country:US
Mailing Address - Phone:415-621-2929
Mailing Address - Fax:
Practice Address - Street 1:1292 PAGE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-3064
Practice Address - Country:US
Practice Address - Phone:415-621-2929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA130340106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist