Healthcare Provider Details

I. General information

NPI: 1265150155
Provider Name (Legal Business Name): RILEY WARREN SMITH LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2022
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 CALIFORNIA ST RM 805
SAN FRANCISCO CA
94118-1510
US

IV. Provider business mailing address

2333 BUCHANAN ST STE 1090
SAN FRANCISCO CA
94115-1925
US

V. Phone/Fax

Practice location:
  • Phone: 415-923-3155
  • Fax:
Mailing address:
  • Phone: 415-923-3155
  • Fax: 415-441-5128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW129114
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: