Provider Information for 1134767437
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MICHAEL THOMAS FILLIPON LICSW
Sex: Male
NPI: 1134767437
Last Updated: 2024-10-02
Certification Date: 2024-10-02
Certification Date: 2024-10-02
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1134767437 | ||||||||||||||||
| Enumeration Date | 2019-12-17 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 1442 16TH AVE SAN FRANCISCO, CA 94122-3510 United States Phone: 603-401-3062 | Fax: | ||||||||||||||||
| Primary Practice Address | 1442 16TH AVE SAN FRANCISCO, CA 94122-3510 United States Phone: 603-401-3062 | Fax: | ||||||||||||||||
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