Provider Demographics
NPI:1376829564
Name:WENAWESER, CRAIG (LMFT #88236)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:WENAWESER
Suffix:
Gender:M
Credentials:LMFT #88236
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 POINT LOBOS AVE
Mailing Address - Street 2:#305
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-1470
Mailing Address - Country:US
Mailing Address - Phone:415-238-1852
Mailing Address - Fax:
Practice Address - Street 1:4052 18TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-2534
Practice Address - Country:US
Practice Address - Phone:415-238-1852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT #88236106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist