Provider Demographics
NPI:1821222936
Name:WILLEY, FRANK TILGHMAN (PHD, MFT)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:TILGHMAN
Last Name:WILLEY
Suffix:
Gender:M
Credentials:PHD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3356 2ND AVE
Mailing Address - Street 2:SUITE H
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-5636
Mailing Address - Country:US
Mailing Address - Phone:619-889-0312
Mailing Address - Fax:
Practice Address - Street 1:3356 2ND AVE
Practice Address - Street 2:SUITE H
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-5636
Practice Address - Country:US
Practice Address - Phone:619-889-0312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 46247106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist