Healthcare Provider Details

I. General information

NPI: 1396299541
Provider Name (Legal Business Name): NANCY CHEUNG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2016
Last Update Date: 05/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVE STE 7M8
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

1001 POTRERO AVE. STE. 7M8
SAN FRANCISCO CA
94110
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-7409
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number22053
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: