Provider Demographics
NPI:1043384548
Name:BRAUN, JEROME EDWARD (MFT)
Entity Type:Individual
Prefix:MR
First Name:JEROME
Middle Name:EDWARD
Last Name:BRAUN
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 MARKET ST
Mailing Address - Street 2:SUITE 1252
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-3002
Mailing Address - Country:US
Mailing Address - Phone:415-984-0501
Mailing Address - Fax:415-984-0502
Practice Address - Street 1:870 MARKET ST
Practice Address - Street 2:SUITE 1252
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3002
Practice Address - Country:US
Practice Address - Phone:415-984-0501
Practice Address - Fax:415-984-0502
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC34656106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist