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NPI Code Detail

MEDICARE: CYNTHIA TERESA PON MSW, LCSW

MEDICARE: CYNTHIA TERESA PON MSW, LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCS 21096CA

General Provider Information

NPI Number : 1326125964
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA TERESA PON MSW, LCSW
Provider Business Mailing Address
First Line : 1380 HOWARD ST
Second Line : 5TH FLOOR
City : SAN FRANCISCO
State : CA
Zip : 94103-2638
Country : US
Telephone Number : 415-255-3699
Fax Number : 415-252-3015
Provider Business Practice Location Address
First Line : 1990 41ST AVE
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94116-1101
Country : US
Telephone Number : 415-753-7400
Fax Number : 415-753-0164
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 05/06/2013

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