Healthcare Provider Details

I. General information

NPI: 1811851934
Provider Name (Legal Business Name): LANEISHA WASHINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2049 GROVE ST
SAN FRANCISCO CA
94117-1123
US

IV. Provider business mailing address

PO BOX 882621
SAN FRANCISCO CA
94188-2621
US

V. Phone/Fax

Practice location:
  • Phone: 415-750-8492
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number113017
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: