Provider Demographics
NPI:1205163219
Name:FRANCIS, TERRY LYNN (MFT)
Entity type:Individual
Prefix:MS
First Name:TERRY
Middle Name:LYNN
Last Name:FRANCIS
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 1:1223 GRAND AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-3457
Mailing Address - Country:US
Mailing Address - Phone:415-721-7341
Mailing Address - Fax:415-721-7341
Practice Address - Street 1:1223 GRAND AVE APT 5
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3457
Practice Address - Country:US
Practice Address - Phone:415-721-7341
Practice Address - Fax:415-721-7341
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47354106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist