Healthcare Provider Details

I. General information

NPI: 1366641532
Provider Name (Legal Business Name): GEORGE CALVIN II LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 KEITH ST
SAN FRANCISCO CA
94124-3231
US

IV. Provider business mailing address

2401 KEITH ST
SAN FRANCISCO CA
94124-3231
US

V. Phone/Fax

Practice location:
  • Phone: 628-217-5650
  • Fax:
Mailing address:
  • Phone: 628-217-5650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number60951
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: