Provider Demographics
NPI:1093225120
Name:GALLAU, KELSEY ELAINE (MFT)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:ELAINE
Last Name:GALLAU
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 BEALE ST FL 12
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94105-1823
Mailing Address - Country:US
Mailing Address - Phone:415-819-4177
Mailing Address - Fax:
Practice Address - Street 1:50 BEALE ST FL 12
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-1823
Practice Address - Country:US
Practice Address - Phone:415-819-4177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA121561106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist