Provider Demographics
NPI:1952512816
Name:ROTHBAUM, HELEN (MFT)
Entity Type:Individual
Prefix:MS
First Name:HELEN
Middle Name:
Last Name:ROTHBAUM
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 MONTE VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-4919
Mailing Address - Country:US
Mailing Address - Phone:510-658-9523
Mailing Address - Fax:
Practice Address - Street 1:1726 FILLMORE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3130
Practice Address - Country:US
Practice Address - Phone:415-567-2877
Practice Address - Fax:510-658-9533
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT21811106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist