Provider Demographics
NPI:1508186719
Name:STREETER, ARTHUR (IMF)
Entity Type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:
Last Name:STREETER
Suffix:
Gender:M
Credentials:IMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 LELAND LANE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:CA
Mailing Address - Zip Code:94565
Mailing Address - Country:US
Mailing Address - Phone:925-628-5477
Mailing Address - Fax:
Practice Address - Street 1:16378 E 14TH STREET
Practice Address - Street 2:#101
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578
Practice Address - Country:US
Practice Address - Phone:510-667-3276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55412106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist