Provider Demographics
NPI:1851714398
Name:PISACANE, PAUL (MFTI)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:PISACANE
Suffix:
Gender:M
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BUENA VISTA AVE E
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-4101
Mailing Address - Country:US
Mailing Address - Phone:415-375-0869
Mailing Address - Fax:
Practice Address - Street 1:609 PRICE AVE
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1463
Practice Address - Country:US
Practice Address - Phone:650-366-8436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health