Provider Demographics
NPI:1881031268
Name:SINGH, SAMITA
Entity Type:Individual
Prefix:MS
First Name:SAMITA
Middle Name:
Last Name:SINGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BAYSIDE VILLAGE PL APT 220
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-4123
Mailing Address - Country:US
Mailing Address - Phone:209-712-2093
Mailing Address - Fax:
Practice Address - Street 1:1309 EVANS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94124-1705
Practice Address - Country:US
Practice Address - Phone:415-206-7678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-26
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100097106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist