Provider Demographics
NPI:1467595488
Name:CALIFORNIA COUNSELING INSTITUTE
Entity Type:Organization
Organization Name:CALIFORNIA COUNSELING INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHAN-SCHERER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:415-752-1702
Mailing Address - Street 1:4614 CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1225
Mailing Address - Country:US
Mailing Address - Phone:415-752-1702
Mailing Address - Fax:415-751-1545
Practice Address - Street 1:4614 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1225
Practice Address - Country:US
Practice Address - Phone:415-752-1702
Practice Address - Fax:415-751-1545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ23203ZMedicare ID - Type Unspecified