Provider Demographics
NPI:1275702011
Name:METZ, CRAIG (MFC 48879)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:METZ
Suffix:
Gender:M
Credentials:MFC 48879
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27071
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-0271
Mailing Address - Country:US
Mailing Address - Phone:415-857-4648
Mailing Address - Fax:
Practice Address - Street 1:2226 MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-5099
Practice Address - Country:US
Practice Address - Phone:415-857-4648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-26
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48879106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA48879OtherLMFT