Healthcare Provider Details

I. General information

NPI: 1780871277
Provider Name (Legal Business Name): APRIL BETH LAX LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2007
Last Update Date: 09/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 ONONDAGA AVE
SAN FRANCISCO CA
94112-3212
US

IV. Provider business mailing address

45 ONONDAGA AVE
SAN FRANCISCO CA
94112-3212
US

V. Phone/Fax

Practice location:
  • Phone: 415-452-2100
  • Fax: 415-452-2193
Mailing address:
  • Phone: 415-452-2100
  • Fax: 415-452-2193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS13821
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: