Provider Demographics
NPI:1780217133
Name:BJORK, ANNE K
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:K
Last Name:BJORK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 TAMAL PLZ STE 270
Mailing Address - Street 2:
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1162
Mailing Address - Country:US
Mailing Address - Phone:415-758-0038
Mailing Address - Fax:
Practice Address - Street 1:100 TAMAL PLZ STE 270
Practice Address - Street 2:
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1162
Practice Address - Country:US
Practice Address - Phone:415-758-0038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94669106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist