Healthcare Provider Details

I. General information

NPI: 1154237162
Provider Name (Legal Business Name): ASHLEY TIMBRELL, LICENSED CLINICAL SOCIAL WORKER, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 FILLMORE ST
SAN FRANCISCO CA
94115-2708
US

IV. Provider business mailing address

2021 FILLMORE ST
SAN FRANCISCO CA
94115-2708
US

V. Phone/Fax

Practice location:
  • Phone: 628-304-5728
  • Fax:
Mailing address:
  • Phone: 628-304-5728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY TIMBRELL
Title or Position: PRESIDENT
Credential: LCSW
Phone: 628-304-5728