Provider Demographics
NPI:1184747602
Name:REDDOCH-HO, MEREDITH HOLCOMB (MFT, MA)
Entity type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:HOLCOMB
Last Name:REDDOCH-HO
Suffix:
Gender:F
Credentials:MFT, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2712 MISSION STREET
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110
Mailing Address - Country:US
Mailing Address - Phone:415-401-2672
Mailing Address - Fax:415-401-2741
Practice Address - Street 1:2712 MISSION STREET
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110
Practice Address - Country:US
Practice Address - Phone:415-401-2672
Practice Address - Fax:415-401-2741
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT84013106H00000X
CAIMF51114101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
9403OtherSFGH INTERNAL USE ONLY
9403OtherCBHS INTERNAL USE ONLY-COMMERCIAL NUMBER