Healthcare Provider Details

I. General information

NPI: 1366563983
Provider Name (Legal Business Name): MANDI LEE HOOD M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 08/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2441 JACKSON ST
SAN FRANCISCO CA
94115-1324
US

IV. Provider business mailing address

925 JONES ST APT 504
SAN FRANCISCO CA
94109-5105
US

V. Phone/Fax

Practice location:
  • Phone: 415-346-6380
  • Fax: 415-346-1058
Mailing address:
  • Phone: 415-567-2947
  • Fax: 415-292-7140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: