Provider Demographics
NPI:1912033580
Name:BUTLER, WENDY ROSE
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:ROSE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 HOWTH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-3117
Mailing Address - Country:US
Mailing Address - Phone:415-586-6060
Mailing Address - Fax:
Practice Address - Street 1:1601 QUESADA AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94124-2334
Practice Address - Country:US
Practice Address - Phone:415-822-5977
Practice Address - Fax:415-822-5943
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)