Provider Demographics
NPI:1366743478
Name:MIYAZAKI MAESHIRO, SAORI (MFT)
Entity type:Individual
Prefix:MS
First Name:SAORI
Middle Name:
Last Name:MIYAZAKI MAESHIRO
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:SAORI
Other - Middle Name:
Other - Last Name:MIYAZAKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1801 BUSH ST.
Mailing Address - Street 2:131E
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5273
Mailing Address - Country:US
Mailing Address - Phone:415-823-0022
Mailing Address - Fax:
Practice Address - Street 1:1801 BUSH ST STE 131E
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5273
Practice Address - Country:US
Practice Address - Phone:415-823-0022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2018-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88036106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist