Provider Demographics
NPI:1225128580
Name:KOREN, SHEILA ANN (MFT)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:ANN
Last Name:KOREN
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 1:524 45TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-2421
Mailing Address - Country:US
Mailing Address - Phone:415-652-2704
Mailing Address - Fax:415-668-6124
Practice Address - Street 1:524 45TH AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-2421
Practice Address - Country:US
Practice Address - Phone:415-652-2704
Practice Address - Fax:415-668-6124
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT35849106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist