Healthcare Provider Details

I. General information

NPI: 1295903409
Provider Name (Legal Business Name): CELAN BEAUSOLEIL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 BUCHANAN ST
SAN FRANCISCO CA
94115-3709
US

IV. Provider business mailing address

1426 FILLMORE ST
SAN FRANCISCO CA
94115-5236
US

V. Phone/Fax

Practice location:
  • Phone: 415-931-9622
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW90790
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: