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NPI 1013077429

NPI 1013077429 : THAIS XANADU WILLIAMS MSW, LCSW : SAN FRANCISCO, CA

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General NPI Number Information
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    NPI Number           |    1013077429
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    Entity Type          |    Individual 
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    Provider Name        |    THAIS XANADU WILLIAMS MSW, LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/08/2006
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    Last Update Date     |    10/20/2008
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Provider Practice Location Address
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    Address Line         |    101 15TH ST 
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    City                 |    SAN FRANCISCO
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    State                |    CA
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    Zip                  |    94103-5103
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    Country              |    US
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    Telephone            |    415-682-3246
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3388 17TH ST 210
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    City                 |    SAN FRANCISCO
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    State                |    CA
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    Zip                  |    94110-7201
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    Country              |    US
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    Telephone            |    857-234-0820
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    24388
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    License Number State |    CA
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