Provider Demographics
NPI:1821405150
Name:BRINKMANN, DIETMAR (LMFT)
Entity Type:Individual
Prefix:MR
First Name:DIETMAR
Middle Name:
Last Name:BRINKMANN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 MARKET ST STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-1375
Mailing Address - Country:US
Mailing Address - Phone:415-255-2517
Mailing Address - Fax:
Practice Address - Street 1:2120 MARKET ST STE 205
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1375
Practice Address - Country:US
Practice Address - Phone:415-255-2517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-18
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52562106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist