Healthcare Provider Details

I. General information

NPI: 1619366598
Provider Name (Legal Business Name): NAKARI MERCEDES RON MSW/ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NAKARI MERCEDES SMALL MSW/ASW

II. Dates (important events)

Enumeration Date: 01/15/2015
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 GOLDEN GATE AVENUE TOM WADDELL URBAN HEALTH CLINIC
SAN FRANCISCO CA
94102
US

IV. Provider business mailing address

230 GOLDEN GATE AVENUE TOM WADDELL URBAN HEALTH CLINIC
SAN FRANCISCO CA
94102
US

V. Phone/Fax

Practice location:
  • Phone: 415-355-7521
  • Fax: 415-674-6378
Mailing address:
  • Phone: 415-355-7521
  • Fax: 415-674-6378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: