Healthcare Provider Details

I. General information

NPI: 1346437167
Provider Name (Legal Business Name): PAMELA SUZANNE LEVY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PAMELA SUZANNE HASKIN

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 02/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 BUSH ST STE 201
SAN FRANCISCO CA
94109-5296
US

IV. Provider business mailing address

1801 BUSH ST STE 201
SAN FRANCISCO CA
94109-5296
US

V. Phone/Fax

Practice location:
  • Phone: 415-823-5432
  • Fax:
Mailing address:
  • Phone: 415-823-5432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number25839
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: