Healthcare Provider Details

I. General information

NPI: 1588573984
Provider Name (Legal Business Name): VIOLET ANNE BUFFALO ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

978 2ND ST STE 200
LAFAYETTE CA
94549-4545
US

IV. Provider business mailing address

251 28TH ST
SAN FRANCISCO CA
94131-2303
US

V. Phone/Fax

Practice location:
  • Phone: 925-386-6037
  • Fax:
Mailing address:
  • Phone: 415-297-1761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW139397
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: