Provider Demographics
NPI:1376617134
Name:FRANCE, DAVID PATRICK (MFT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:PATRICK
Last Name:FRANCE
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 1:1191 SIMMONS LN
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-1735
Mailing Address - Country:US
Mailing Address - Phone:415-895-6795
Mailing Address - Fax:
Practice Address - Street 1:1191 SIMMONS LN
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-1735
Practice Address - Country:US
Practice Address - Phone:415-895-6795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79260106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1376617134OtherMEDI-CAL