Provider Demographics
NPI:1043003767
Name:NASH, CHARISSE (AMFT, MA, BS)
Entity type:Individual
Prefix:MS
First Name:CHARISSE
Middle Name:
Last Name:NASH
Suffix:
Gender:F
Credentials:AMFT, MA, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 LOMBARD ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-1524
Mailing Address - Country:US
Mailing Address - Phone:415-595-2551
Mailing Address - Fax:
Practice Address - Street 1:1996 UNION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-4230
Practice Address - Country:US
Practice Address - Phone:415-595-2551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT149131106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist