Healthcare Provider Details

I. General information

NPI: 1275918310
Provider Name (Legal Business Name): YOLY MAGALLANES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

759 S VAN NESS AVE
SAN FRANCISCO CA
94110-1908
US

IV. Provider business mailing address

759 S VAN NESS AVE
SAN FRANCISCO CA
94110-1908
US

V. Phone/Fax

Practice location:
  • Phone: 415-642-4550
  • Fax:
Mailing address:
  • Phone: 415-642-4550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW130494
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: