Provider Demographics
NPI:1972881191
Name:GEORGIEVA, RALITSA CHAVDAROVA (MFT)
Entity type:Individual
Prefix:
First Name:RALITSA
Middle Name:CHAVDAROVA
Last Name:GEORGIEVA
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 1:1385 MISSION ST
Mailing Address - Street 2:SUITE 240
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2623
Mailing Address - Country:US
Mailing Address - Phone:415-864-4002
Mailing Address - Fax:415-864-7093
Practice Address - Street 1:1385 MISSION ST
Practice Address - Street 2:SUITE 240
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2623
Practice Address - Country:US
Practice Address - Phone:415-864-4002
Practice Address - Fax:415-864-7093
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84809106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist