Healthcare Provider Details

I. General information

NPI: 1760636740
Provider Name (Legal Business Name): SALLY BUEHLER MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2008
Last Update Date: 11/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S ELISEO DR
GREENBRAE CA
94904-2134
US

IV. Provider business mailing address

18 TURNAGAIN RD
KENTFIELD CA
94904-2717
US

V. Phone/Fax

Practice location:
  • Phone: 415-461-5277
  • Fax: 415-461-8237
Mailing address:
  • Phone: 415-461-2278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS 2732
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: