Provider Demographics
NPI:1952666810
Name:HEARN, BRUCE (MA, LMFT)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:
Last Name:HEARN
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 401101
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94140-1101
Mailing Address - Country:US
Mailing Address - Phone:415-598-8956
Mailing Address - Fax:
Practice Address - Street 1:220 MONTGOMERY ST
Practice Address - Street 2:SUITE 317
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-3402
Practice Address - Country:US
Practice Address - Phone:415-598-8956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-06
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT-79269106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist