Provider Demographics
NPI:1326147067
Name:BYERS, HOLLIS ANN (LMFT)
Entity Type:Individual
Prefix:
First Name:HOLLIS
Middle Name:ANN
Last Name:BYERS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 SAN ANSELMO AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SAN ANSELMO
Mailing Address - State:CA
Mailing Address - Zip Code:94960-2632
Mailing Address - Country:US
Mailing Address - Phone:415-455-5884
Mailing Address - Fax:
Practice Address - Street 1:508 SAN ANSELMO AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:SAN ANSELMO
Practice Address - State:CA
Practice Address - Zip Code:94960-2632
Practice Address - Country:US
Practice Address - Phone:415-455-5884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 37904106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist