Provider Demographics
NPI:1972945459
Name:MEYERS, JILL ANN (IMFT)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:ANN
Last Name:MEYERS
Suffix:
Gender:F
Credentials:IMFT
Other - Prefix:MRS
Other - First Name:JILL
Other - Middle Name:ANN
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:368 FELL ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5144
Mailing Address - Country:US
Mailing Address - Phone:415-861-0828
Mailing Address - Fax:415-861-0257
Practice Address - Street 1:52 DORE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-3828
Practice Address - Country:US
Practice Address - Phone:415-553-3100
Practice Address - Fax:415-553-3118
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69365101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health