Healthcare Provider Details

I. General information

NPI: 1902737075
Provider Name (Legal Business Name): AGNIESZKA S GORSKA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3264 20TH ST
SAN FRANCISCO CA
94110-2725
US

IV. Provider business mailing address

1515 QUINTARA ST
SAN FRANCISCO CA
94116-1273
US

V. Phone/Fax

Practice location:
  • Phone: 415-573-8360
  • Fax:
Mailing address:
  • Phone: 415-759-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number23583
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: