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General NPI Number Information
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NPI Number | 1285381236
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Entity Type | Organization
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Legal Business Name | QUANTUM MINDFRAME LICENSED CLINICAL SOCIAL WORKER INC.
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Dates
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Enumeration Date | 03/08/2022
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Last Update Date | 03/08/2022
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Provider Practice Location Address
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Address Line | 216 FAIR OAKS ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-2929
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Country | US
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Telephone | 415-549-9309
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Fax |
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Provider Business Mailing Address
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Address Line | 4104 24TH ST UNIT 1008
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-3615
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Country | US
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Telephone | 415-549-9309
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | ESMERALDA VERMA
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Credential | LCSW
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Telephone | 415-549-9309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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