Provider Demographics
NPI:1932612488
Name:FRANCE, EMILY G
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:G
Last Name:FRANCE
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 1:974 RALSTON AVE STE 9
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002-2249
Mailing Address - Country:US
Mailing Address - Phone:650-594-1060
Mailing Address - Fax:
Practice Address - Street 1:974 RALSTON AVE STE 9
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-2249
Practice Address - Country:US
Practice Address - Phone:650-594-1060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31475106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA31475OtherCA DEPARTMENT OF CONSUMER AFFAIRS