Provider Demographics
NPI:1285958157
Name:TATE, VANESSA BETH (LMFT)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:BETH
Last Name:TATE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:664 SIERRA POINT RD
Mailing Address - Street 2:
Mailing Address - City:BRISBANE
Mailing Address - State:CA
Mailing Address - Zip Code:94005-1622
Mailing Address - Country:US
Mailing Address - Phone:415-794-8327
Mailing Address - Fax:
Practice Address - Street 1:55 NEW MONTGOMERY ST
Practice Address - Street 2:SUITE 804
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-3412
Practice Address - Country:US
Practice Address - Phone:415-820-1661
Practice Address - Fax:866-232-8398
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-22
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48163106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist