Provider Demographics
NPI:1215117973
Name:BAYARD, MARION LISA (MFT)
Entity type:Individual
Prefix:
First Name:MARION
Middle Name:LISA
Last Name:BAYARD
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 1:1460 PINE ST
Mailing Address - Street 2:BRIDGE TO WELLNESS
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4720
Mailing Address - Country:US
Mailing Address - Phone:415-202-0580
Mailing Address - Fax:
Practice Address - Street 1:1460 PINE ST
Practice Address - Street 2:BRIDGE TO WELLNESS
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4720
Practice Address - Country:US
Practice Address - Phone:415-202-0580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-11
Last Update Date:2007-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36610106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist