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General NPI Number Information
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NPI Number | 1407974439
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Entity Type | Individual
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Provider Name | LOURDES BETANCOURT L.C.S.W
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Gender | Female
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 01/03/2022
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Provider Practice Location Address
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Address Line | 4141 GEARY BLVD 3RD FLOOR
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-3109
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Country | US
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Telephone | 415-833-2957
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Fax |
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Provider Business Mailing Address
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Address Line | 1590 26TH AVE APT 10
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-3297
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Country | US
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Telephone | 209-485-2096
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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 | ASW 27117
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW 65198
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License Number State | CA
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