Provider Demographics
NPI:1720189038
Name:CUMMINGS, ANN (MFT)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:BANO
Other - Middle Name:ANN
Other - Last Name:CUMMINGS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:35 MARIA DR
Mailing Address - Street 2:SUITE# 863
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-3548
Mailing Address - Country:US
Mailing Address - Phone:707-778-8090
Mailing Address - Fax:707-778-2076
Practice Address - Street 1:35 MARIA DR
Practice Address - Street 2:SUITE# 863
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94954-3548
Practice Address - Country:US
Practice Address - Phone:707-778-8090
Practice Address - Fax:707-778-2076
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16231106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist