Provider Demographics
NPI:1396881165
Name:PARKER, RYAN EDWARD (MFT)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:EDWARD
Last Name:PARKER
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2513 24TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3556
Mailing Address - Country:US
Mailing Address - Phone:805-252-1587
Mailing Address - Fax:
Practice Address - Street 1:2513 24TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3556
Practice Address - Country:US
Practice Address - Phone:805-252-1587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52345106H00000X
CA51701106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist