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General NPI Number Information
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NPI Number | 1730388174
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Entity Type | Individual
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Provider Name | KAYE SUZANNE ANDERSON LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 12/29/2021
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Provider Practice Location Address
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Address Line | 1265 65TH ST
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City | EMERYVILLE
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State | CA
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Zip | 94608-1110
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Country | US
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Telephone | 510-595-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 586 PENNSYLVANIA AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94107-2914
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Country | US
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Telephone | 510-919-2783
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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 | 19013
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License Number State | CA
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