Provider Demographics
NPI:1720138209
Name:HENNING, DAVID ALAN (MFT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ALAN
Last Name:HENNING
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-1111
Mailing Address - Country:US
Mailing Address - Phone:415-852-8484
Mailing Address - Fax:415-744-1160
Practice Address - Street 1:126 CHURCH STREET
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1111
Practice Address - Country:US
Practice Address - Phone:415-852-8484
Practice Address - Fax:415-744-1160
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35469106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist