Healthcare Provider Details

I. General information

NPI: 1437970431
Provider Name (Legal Business Name): JACQUELINE O'BOYLE LCSW, CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2024
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 HAYES ST APT 18
SAN FRANCISCO CA
94117-1013
US

IV. Provider business mailing address

2200 HAYES ST # 3N
SAN FRANCISCO CA
94117-1013
US

V. Phone/Fax

Practice location:
  • Phone: 415-209-3199
  • Fax:
Mailing address:
  • Phone: 415-209-3199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number137314
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: