Healthcare Provider Details

I. General information

NPI: 1568313302
Provider Name (Legal Business Name): AMANDA NANCE ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2026
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 DIVISADERO ST STE 1
SAN FRANCISCO CA
94115-2113
US

IV. Provider business mailing address

2024 DIVISADERO ST STE 1
SAN FRANCISCO CA
94115-2113
US

V. Phone/Fax

Practice location:
  • Phone: 415-439-0131
  • Fax:
Mailing address:
  • Phone: 415-439-0131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW136898
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: