Provider Demographics
NPI:1598926883
Name:CORSALE, ELIZABETH ANN (ELIZABETH CORSALE)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:CORSALE
Suffix:
Gender:F
Credentials:ELIZABETH CORSALE
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:CORSALE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:1738 UNION ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-4441
Mailing Address - Country:US
Mailing Address - Phone:415-267-6965
Mailing Address - Fax:
Practice Address - Street 1:1738 UNION ST
Practice Address - Street 2:SUITE 300
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-4441
Practice Address - Country:US
Practice Address - Phone:415-267-6965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36769106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist