Provider Demographics
NPI:1245663954
Name:LOEFFLER, MICHAEL J JR (MFT# 53839)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:J
Last Name:LOEFFLER
Suffix:JR
Gender:M
Credentials:MFT# 53839
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 GOUGH, SUITE 111
Mailing Address - Street 2:SAN FRANCISCO, CA 94102
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117
Mailing Address - Country:US
Mailing Address - Phone:415-938-7920
Mailing Address - Fax:
Practice Address - Street 1:211 GOUGH ST STE 111
Practice Address - Street 2:SAN FRANCISCO, CA 94102
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-6802
Practice Address - Country:US
Practice Address - Phone:415-938-7920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53839106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist