Provider Demographics
NPI:1134415342
Name:NOTTAGE, ROMIE JANE (LMFT)
Entity type:Individual
Prefix:
First Name:ROMIE
Middle Name:JANE
Last Name:NOTTAGE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1171 MISSION ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-1519
Mailing Address - Country:US
Mailing Address - Phone:707-337-9451
Mailing Address - Fax:
Practice Address - Street 1:1171 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-1519
Practice Address - Country:US
Practice Address - Phone:707-337-9451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-26
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA93934106H00000X
CA119577106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist