Provider Demographics
NPI:1093025603
Name:FORQUER, KATHERINE FAYE
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:FAYE
Last Name:FORQUER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1385 MASONIC AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-4011
Mailing Address - Country:US
Mailing Address - Phone:314-249-8689
Mailing Address - Fax:
Practice Address - Street 1:1301 PIERCE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-4005
Practice Address - Country:US
Practice Address - Phone:415-563-8200
Practice Address - Fax:415-563-5985
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)