Healthcare Provider Details

I. General information

NPI: 1467544098
Provider Name (Legal Business Name): SANDRA OLSHAK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

582 MARKET ST STE 1608
SAN FRANCISCO CA
94104-5317
US

IV. Provider business mailing address

582 MARKET ST STE 1608
SAN FRANCISCO CA
94104-5317
US

V. Phone/Fax

Practice location:
  • Phone: 833-931-1716
  • Fax: 866-519-5427
Mailing address:
  • Phone: 833-931-1716
  • Fax: 866-519-5427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149 007934
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number62848
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number135278
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: