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General NPI Number Information
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NPI Number | 1578231585
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Entity Type | Individual
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Provider Name | JESSICA STUHL
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Gender | Female
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Dates
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Enumeration Date | 09/03/2021
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Last Update Date | 01/26/2022
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Provider Practice Location Address
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Address Line | 250 BON AIR RD
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City | GREENBRAE
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State | CA
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Zip | 94904-1702
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Country | US
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Telephone | 415-925-7663
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Fax |
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Provider Business Mailing Address
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Address Line | 75 ROWLAND WAY
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City | NOVATO
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State | CA
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Zip | 94945-5037
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Country | US
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Telephone | 628-336-5460
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Fax | 628-240-2141
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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 | LCSW68110
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License Number State | CA
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