Healthcare Provider Details

I. General information

NPI: 1538316377
Provider Name (Legal Business Name): MISS ANGELI LUCIA BUENO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2008
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2238 GEARY BLVD FL 8
SAN FRANCISCO CA
94115-3416
US

IV. Provider business mailing address

171 SAGE ST
DALY CITY CA
94014-2180
US

V. Phone/Fax

Practice location:
  • Phone: 415-833-2000
  • Fax:
Mailing address:
  • Phone: 707-315-0941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number80830
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: