Provider Demographics
NPI:1558533349
Name:RICH, WESLEY EVERETT III (MFT)
Entity Type:Individual
Prefix:
First Name:WESLEY
Middle Name:EVERETT
Last Name:RICH
Suffix:III
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 1:1426 FILLMORE ST
Mailing Address - Street 2:204
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-5236
Mailing Address - Country:US
Mailing Address - Phone:415-561-0631
Mailing Address - Fax:415-563-8017
Practice Address - Street 1:1426 FILLMORE ST
Practice Address - Street 2:204
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-5236
Practice Address - Country:US
Practice Address - Phone:415-561-0631
Practice Address - Fax:415-563-8017
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22681106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist