Provider Demographics
NPI:1609281377
Name:COYLE, ANNE MARIA (MA MFT)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:MARIA
Last Name:COYLE
Suffix:
Gender:F
Credentials:MA MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:534 NORVELL ST
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-3242
Mailing Address - Country:US
Mailing Address - Phone:510-394-7684
Mailing Address - Fax:
Practice Address - Street 1:534 NORVELL ST
Practice Address - Street 2:
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530-3242
Practice Address - Country:US
Practice Address - Phone:510-394-7684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-21
Last Update Date:2014-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34911106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist