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General NPI Number Information
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NPI Number | 1679024855
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Entity Type | Individual
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Provider Name | LARK ENDEAN NIERENBERG LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/21/2016
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Last Update Date | 01/11/2022
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Provider Practice Location Address
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Address Line | 2211 POST ST STE 300
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-3442
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Country | US
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Telephone | 415-236-0655
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 225141
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-5141
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Country | US
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Telephone | 415-236-0655
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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 | 103758
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ASW74080
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License Number State | CA
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