Provider Demographics
NPI:1861541302
Name:HORN, AMY ANASTASIA (MFT)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:ANASTASIA
Last Name:HORN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:BETH
Other - Last Name:HARRITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA,MFT
Mailing Address - Street 1:4831 GEARY BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-2910
Mailing Address - Country:US
Mailing Address - Phone:415-273-1132
Mailing Address - Fax:206-888-6571
Practice Address - Street 1:4831 GEARY BLVD
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-2910
Practice Address - Country:US
Practice Address - Phone:415-273-1132
Practice Address - Fax:206-888-6571
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC32515101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist