Provider Demographics
NPI:1275693970
Name:GENTHE, WILLIAM F (MFT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:F
Last Name:GENTHE
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 1:5630 DEMPSEY PL
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-8061
Mailing Address - Country:US
Mailing Address - Phone:707-546-8341
Mailing Address - Fax:
Practice Address - Street 1:5630 DEMPSEY PL
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-8061
Practice Address - Country:US
Practice Address - Phone:707-546-8341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC29973106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist