Provider Demographics
NPI:1568692432
Name:PERELMAN, JODI (MFT)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:PERELMAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2339 3RD ST STE 24
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-3191
Mailing Address - Country:US
Mailing Address - Phone:415-420-5962
Mailing Address - Fax:
Practice Address - Street 1:2339 3RD ST STE 24
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-3191
Practice Address - Country:US
Practice Address - Phone:415-435-7559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-24
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45307106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist