Provider Demographics
NPI:1528093028
Name:O'SHEA, MOLLY ANN (MFT)
Entity type:Individual
Prefix:MS
First Name:MOLLY
Middle Name:ANN
Last Name:O'SHEA
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 1:2645 OCEAN AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-1646
Mailing Address - Country:US
Mailing Address - Phone:415-835-8755
Mailing Address - Fax:
Practice Address - Street 1:2645 OCEAN AVE STE 206
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-1646
Practice Address - Country:US
Practice Address - Phone:415-835-8755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38109106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist