Provider Demographics
NPI:1316331275
Name:MATHER, JASPER CORNELIUS (LMFT)
Entity type:Individual
Prefix:
First Name:JASPER
Middle Name:CORNELIUS
Last Name:MATHER
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 1:2443 FILLMORE ST # 380-8784
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1814
Mailing Address - Country:US
Mailing Address - Phone:415-393-2585
Mailing Address - Fax:415-393-2909
Practice Address - Street 1:2443 FILLMORE ST # 380-8784
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-1814
Practice Address - Country:US
Practice Address - Phone:415-393-2585
Practice Address - Fax:415-393-2909
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-27
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7900101YM0800X
CA134528106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health