Provider Demographics
NPI:1134507742
Name:360THERAPY
Entity Type:Organization
Organization Name:360THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIO
Authorized Official - Middle Name:LINO
Authorized Official - Last Name:ZANET
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:415-813-5454
Mailing Address - Street 1:735 GEARY ST APT 503
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-7327
Mailing Address - Country:US
Mailing Address - Phone:415-225-4275
Mailing Address - Fax:
Practice Address - Street 1:3150 18TH ST APT 238
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2074
Practice Address - Country:US
Practice Address - Phone:415-813-5454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-14
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80242106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA80242OtherBBS