Provider Demographics
NPI:1265598239
Name:YUDELSON, STEVEN J (MS, MED)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:J
Last Name:YUDELSON
Suffix:
Gender:M
Credentials:MS, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 LYON ST
Mailing Address - Street 2:#6
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-1329
Mailing Address - Country:US
Mailing Address - Phone:415-346-4539
Mailing Address - Fax:415-346-4539
Practice Address - Street 1:426 LYON ST
Practice Address - Street 2:#6
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1329
Practice Address - Country:US
Practice Address - Phone:415-346-4539
Practice Address - Fax:415-346-4539
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT18689106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist