Provider Demographics
NPI:1063691459
Name:TOTTEN, JON E (COUNSELOR)
Entity type:Individual
Prefix:MR
First Name:JON
Middle Name:E
Last Name:TOTTEN
Suffix:
Gender:M
Credentials:COUNSELOR
Other - Prefix:MR
Other - First Name:JON
Other - Middle Name:E
Other - Last Name:TOTTEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RAS
Mailing Address - Street 1:2906 CESAR CHAVEZ
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-4808
Mailing Address - Country:US
Mailing Address - Phone:415-652-3975
Mailing Address - Fax:
Practice Address - Street 1:2906 CESAR CHAVEZ
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4808
Practice Address - Country:US
Practice Address - Phone:415-652-3975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YOOOOOX101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor