Healthcare Provider Details

I. General information

NPI: 1396460408
Provider Name (Legal Business Name): ASHLEY LEATHERS TIMBRELL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY ELIZABETH LEATHERS LMSW

II. Dates (important events)

Enumeration Date: 10/11/2022
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 FILLMORE ST
SAN FRANCISCO CA
94115-2708
US

IV. Provider business mailing address

2021 FILLMORE ST
SAN FRANCISCO CA
94115-2708
US

V. Phone/Fax

Practice location:
  • Phone: 628-304-5728
  • Fax:
Mailing address:
  • Phone: 628-304-5728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number66011
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: