Healthcare Provider Details
I. General information
NPI: 1598813032
Provider Name (Legal Business Name): WILLIAM PETER AMARAL L.C.S.W.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3884 24TH ST
SAN FRANCISCO CA
94114-3839
US
IV. Provider business mailing address
379 CHURCH ST UNIT 401
SAN FRANCISCO CA
94114-4015
US
V. Phone/Fax
- Phone: 415-724-0866
- Fax:
- Phone: 415-724-0866
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | LCS 22812 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: