Provider Demographics
NPI:1811565781
Name:PARISH, NATHANIEL WELLS
Entity type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:WELLS
Last Name:PARISH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 GENERAL KENNEDY AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94129-1405
Mailing Address - Country:US
Mailing Address - Phone:415-244-6933
Mailing Address - Fax:
Practice Address - Street 1:1007 GENERAL KENNEDY AVE STE 4
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94129-1405
Practice Address - Country:US
Practice Address - Phone:415-244-6933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-16
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA152889106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist