Healthcare Provider Details

I. General information

NPI: 1962731539
Provider Name (Legal Business Name): ESTRELLA ANGELINA FICHTER MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2009
Last Update Date: 12/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 EVANS AVE
SAN FRANCISCO CA
94124-1430
US

IV. Provider business mailing address

1885 MISSION ST
SAN FRANCISCO CA
94103-3501
US

V. Phone/Fax

Practice location:
  • Phone: 415-970-7500
  • Fax:
Mailing address:
  • Phone: 415-554-1431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW 24054
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: