Provider Demographics
NPI:1659395002
Name:FORRAY, THOMAS (LMFT -CALIFORNIA)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:FORRAY
Suffix:
Gender:M
Credentials:LMFT -CALIFORNIA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 BON AIR RD
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-1702
Mailing Address - Country:US
Mailing Address - Phone:415-299-9847
Mailing Address - Fax:415-507-4160
Practice Address - Street 1:250 BON AIR RD
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-1702
Practice Address - Country:US
Practice Address - Phone:415-299-9847
Practice Address - Fax:415-507-4160
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMF 15861106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMF 15861OtherLIC. MARRIAGE/FAMILY THER
IN24731OtherMASTER ADDICTIONS COUNS.
IN16637OtherCERT. CRIMINAL JUSTICE SP