Healthcare Provider Details

I. General information

NPI: 1710651880
Provider Name (Legal Business Name): LILY ZMACHINSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2021
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 S VAN NESS AVE
SAN FRANCISCO CA
94110-1908
US

IV. Provider business mailing address

755 S VAN NESS AVE
SAN FRANCISCO CA
94110-1908
US

V. Phone/Fax

Practice location:
  • Phone: 415-642-4525
  • Fax:
Mailing address:
  • Phone: 415-642-4525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number102097
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number102097
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: