Provider Demographics
NPI:1144467432
Name:WILFORD, ANNE CAROLYN I (MA MFT)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:CAROLYN
Last Name:WILFORD
Suffix:I
Gender:F
Credentials:MA MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 ADELINE ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-2264
Mailing Address - Country:US
Mailing Address - Phone:510-287-9828
Mailing Address - Fax:
Practice Address - Street 1:2820 ADELINE ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94703-2264
Practice Address - Country:US
Practice Address - Phone:510-287-9828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC32496106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist