Provider Demographics
NPI:1619020328
Name:COMSTOCK-FRANCIS, PAULA ELAINE
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:ELAINE
Last Name:COMSTOCK-FRANCIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:ELAINE
Other - Last Name:COMSTOCK-FRANCIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BS, MA, LMFT
Mailing Address - Street 1:207 WHITE OAK CIR
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-1955
Mailing Address - Country:US
Mailing Address - Phone:925-301-7968
Mailing Address - Fax:
Practice Address - Street 1:2926 LONETREE WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509
Practice Address - Country:US
Practice Address - Phone:925-301-7968
Practice Address - Fax:707-981-8340
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT #45562106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7434133Medicare PIN