Healthcare Provider Details

I. General information

NPI: 1174608327
Provider Name (Legal Business Name): MOLLY W. LUCIER ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 VALPARAISO ST
SAN FRANCISCO CA
94133-2617
US

IV. Provider business mailing address

18 VALPARAISO ST
SAN FRANCISCO CA
94133-2617
US

V. Phone/Fax

Practice location:
  • Phone: 415-581-0449
  • Fax: 415-581-0458
Mailing address:
  • Phone: 415-581-0449
  • Fax: 415-581-0458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number20825
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: