Provider Demographics
NPI:1649299751
Name:CENKNER, GEORGE F (MA, MFT)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:F
Last Name:CENKNER
Suffix:
Gender:M
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:852 MINNESOTA AVE
Mailing Address - Street 2:#117
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-2453
Mailing Address - Country:US
Mailing Address - Phone:408-279-4878
Mailing Address - Fax:
Practice Address - Street 1:1475 SARATOGA AVE
Practice Address - Street 2:#100
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-4900
Practice Address - Country:US
Practice Address - Phone:408-463-6140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC42621106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist