Provider Demographics
NPI:1215178934
Name:GHEORGHE, COSMIN ION (MFT)
Entity Type:Individual
Prefix:MR
First Name:COSMIN
Middle Name:ION
Last Name:GHEORGHE
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 1:353 KEARNY ST
Mailing Address - Street 2:SUITE 35
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-3227
Mailing Address - Country:US
Mailing Address - Phone:415-279-8240
Mailing Address - Fax:
Practice Address - Street 1:353 KEARNY ST
Practice Address - Street 2:SUITE 35
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-3227
Practice Address - Country:US
Practice Address - Phone:415-279-8240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42242106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist