Provider Demographics
NPI:1275672537
Name:HIDALGO L., SAUL (MFTI)
Entity Type:Individual
Prefix:
First Name:SAUL
Middle Name:
Last Name:HIDALGO L.
Suffix:
Gender:M
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3382 26TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-4632
Mailing Address - Country:US
Mailing Address - Phone:415-647-4709
Mailing Address - Fax:415-647-4718
Practice Address - Street 1:3382 26TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4632
Practice Address - Country:US
Practice Address - Phone:415-647-4709
Practice Address - Fax:415-647-4718
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF50047106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAIMF50047OtherMFT INTERN