Provider Demographics
NPI:1023176906
Name:SHULMAN, PHYLLIS S (PHD, MFT)
Entity type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:S
Last Name:SHULMAN
Suffix:
Gender:F
Credentials:PHD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 EVELYN WAY
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-1730
Mailing Address - Country:US
Mailing Address - Phone:415-731-4724
Mailing Address - Fax:415-665-5454
Practice Address - Street 1:149 EVELYN WAY
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94127-1730
Practice Address - Country:US
Practice Address - Phone:415-731-4724
Practice Address - Fax:415-665-5454
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT25844101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health