Provider Demographics
NPI:1720299902
Name:ZLATCHIN, CARL (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:
Last Name:ZLATCHIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2456 BUSH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3106
Mailing Address - Country:US
Mailing Address - Phone:415-567-6809
Mailing Address - Fax:415-567-6309
Practice Address - Street 1:2456 BUSH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3106
Practice Address - Country:US
Practice Address - Phone:415-567-6809
Practice Address - Fax:415-567-6309
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 4277103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical