| NPI | 1336812924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE KOCEN Credentialing 415-851-0195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor Mental Health | |
| 101YP2500X Counselor Professional | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker Clinical | |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2022-05-12 |