Healthcare Provider Details

I. General information

NPI: 1255585113
Provider Name (Legal Business Name): THARY DUONG ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2008
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2290 14TH AVE
SAN FRANCISCO CA
94116-1841
US

IV. Provider business mailing address

1515 QUINTARA ST
SAN FRANCISCO CA
94116-1273
US

V. Phone/Fax

Practice location:
  • Phone: 415-759-2783
  • Fax:
Mailing address:
  • Phone: 415-242-2615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number74796
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: