Provider Demographics
NPI:1457702557
Name:FELISE, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:FELISE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 HAIGHT ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-6127
Mailing Address - Country:US
Mailing Address - Phone:415-503-2386
Mailing Address - Fax:415-934-6867
Practice Address - Street 1:214 HAIGHT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-6127
Practice Address - Country:US
Practice Address - Phone:415-503-2386
Practice Address - Fax:415-934-6867
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)