Individual
ANNISSYAH AFIANTI ALAMSYAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3626 BALBOA ST, SAN FRANCISCO, CA 94121-2604
(415) 668-5955
(415) 668-0246
Mailing address
3626 BALBOA ST, SAN FRANCISCO, CA 94121-2604
(415) 668-5955
(415) 668-0246
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/14/2014
Last updated
08/26/2019
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