Provider Demographics
NPI:1669808069
Name:PUTILINA-NAYLOR, ANASTASSIA A (LMFT #103042)
Entity type:Individual
Prefix:
First Name:ANASTASSIA
Middle Name:A
Last Name:PUTILINA-NAYLOR
Suffix:
Gender:F
Credentials:LMFT #103042
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2681 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-2912
Mailing Address - Country:US
Mailing Address - Phone:415-682-3205
Mailing Address - Fax:
Practice Address - Street 1:2681 28TH AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94116-2912
Practice Address - Country:US
Practice Address - Phone:415-681-3211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-18
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFTI #IMF 82899106H00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator