Provider Demographics
NPI:1306234612
Name:FERIA, JOSE (LMFT)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:FERIA
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 VAN NESS AVE STE 1135
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-3621
Mailing Address - Country:US
Mailing Address - Phone:628-222-3517
Mailing Address - Fax:628-246-8290
Practice Address - Street 1:855 BRANNAN STREET UNIT 451
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103
Practice Address - Country:US
Practice Address - Phone:628-222-3517
Practice Address - Fax:628-246-8290
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-08
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF#76396106H00000X
CALMFT107842106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist