Provider Demographics
NPI:1710101944
Name:CIOFALO, MARY H (MFT)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:H
Last Name:CIOFALO
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 1:1801 BUSH ST
Mailing Address - Street 2:SUITE 132
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5239
Mailing Address - Country:US
Mailing Address - Phone:415-824-4623
Mailing Address - Fax:
Practice Address - Street 1:1801 BUSH ST
Practice Address - Street 2:SUITE 132
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5239
Practice Address - Country:US
Practice Address - Phone:415-824-4623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMV16216106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist