Provider Demographics
NPI:1851621189
Name:KANTARCIOGLU ELLIOTT, FERHAN (MFT)
Entity Type:Individual
Prefix:
First Name:FERHAN
Middle Name:
Last Name:KANTARCIOGLU ELLIOTT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4026 PIEDMONT AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5209
Mailing Address - Country:US
Mailing Address - Phone:510-496-3449
Mailing Address - Fax:
Practice Address - Street 1:4026 PIEDMONT AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5209
Practice Address - Country:US
Practice Address - Phone:510-496-3449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47341106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist