Provider Demographics
NPI:1104370071
Name:BORGIR, ASHA (LMFT)
Entity Type:Individual
Prefix:
First Name:ASHA
Middle Name:
Last Name:BORGIR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:TAE
Other - Last Name:LITTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:2609 MCGEE AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-1833
Mailing Address - Country:US
Mailing Address - Phone:510-282-5733
Mailing Address - Fax:
Practice Address - Street 1:2609 MCGEE AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94703-1833
Practice Address - Country:US
Practice Address - Phone:510-282-5733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-09
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51302106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist