Healthcare Provider Details

I. General information

NPI: 1083409031
Provider Name (Legal Business Name): SHAINAL CHAND LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2025
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2403 KEITH ST
SAN FRANCISCO CA
94124-3231
US

IV. Provider business mailing address

125 BELMONT AVE
SOUTH SAN FRANCISCO CA
94080-1617
US

V. Phone/Fax

Practice location:
  • Phone: 628-217-5620
  • Fax:
Mailing address:
  • Phone: 650-296-2838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number119600
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: