Provider Demographics
NPI:1811041536
Name:VOROBIEVA, EKATERINA V (MA)
Entity Type:Individual
Prefix:
First Name:EKATERINA
Middle Name:V
Last Name:VOROBIEVA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1326 CLEMENT ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1028
Mailing Address - Country:US
Mailing Address - Phone:415-601-4274
Mailing Address - Fax:
Practice Address - Street 1:4333 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1376
Practice Address - Country:US
Practice Address - Phone:415-601-4274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC46349106H00000X
CAIMF 49558106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist