Provider Demographics
NPI:1992103998
Name:EASTON, DOROTHY MARGUERITE (MA, MFT)
Entity type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:MARGUERITE
Last Name:EASTON
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:MS
Other - First Name:DOSSIE
Other - Middle Name:
Other - Last Name:EASTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, MFT
Mailing Address - Street 1:406 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-2812
Mailing Address - Country:US
Mailing Address - Phone:415-752-7455
Mailing Address - Fax:
Practice Address - Street 1:406 16TH AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-2812
Practice Address - Country:US
Practice Address - Phone:415-752-7455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27782106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist