MEDICARE: LINDA G ROSE 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
1	1041C0700X	Clinical Social Worker	LCS#15026	CA

General Provider Information

NPI Number	:	1528149861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA G ROSE LCSW

Provider Business Mailing Address
First Line	:	278 RANDALL ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94131-2751
Country	:	US
Telephone Number	:	415-643-3996
Fax Number	:	415-643-0982

Provider Business Practice Location Address
First Line	:	278 RANDALL ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94131-2751
Country	:	US
Telephone Number	:	415-643-3996
Fax Number	:	415-643-0982

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	07/08/2007

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