Provider Demographics
NPI:1700982931
Name:HITTELMAN, GEORGYN JUDITH (MFT, PHD)
Entity type:Individual
Prefix:DR
First Name:GEORGYN
Middle Name:JUDITH
Last Name:HITTELMAN
Suffix:
Gender:F
Credentials:MFT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1615
Mailing Address - Country:US
Mailing Address - Phone:415-924-8606
Mailing Address - Fax:415-924-4812
Practice Address - Street 1:4 PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1615
Practice Address - Country:US
Practice Address - Phone:415-924-8606
Practice Address - Fax:415-924-4812
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 15350106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist