Provider Demographics
NPI:1477078715
Name:MILTON, VERSIL (AMFT #104168)
Entity Type:Individual
Prefix:MR
First Name:VERSIL
Middle Name:
Last Name:MILTON
Suffix:
Gender:M
Credentials:AMFT #104168
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 8TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-3910
Mailing Address - Country:US
Mailing Address - Phone:415-769-6251
Mailing Address - Fax:
Practice Address - Street 1:201 8TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-3910
Practice Address - Country:US
Practice Address - Phone:415-769-6251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104168106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist