Provider Demographics
NPI:1215753827
Name:DUSENBERRY, PHALYN ZIRKEL (SUDRC#19898)
Entity type:Individual
Prefix:
First Name:PHALYN
Middle Name:ZIRKEL
Last Name:DUSENBERRY
Suffix:
Gender:
Credentials:SUDRC#19898
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1563 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2543
Mailing Address - Country:US
Mailing Address - Phone:415-762-3700
Mailing Address - Fax:415-865-0119
Practice Address - Street 1:890 HAYES ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-2615
Practice Address - Country:US
Practice Address - Phone:415-762-3700
Practice Address - Fax:415-865-0119
Is Sole Proprietor?:No
Enumeration Date:2024-11-27
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)