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NPI Code Detail

MEDICARE: ELEANOR LOUISE HERTZLER LCSW

MEDICARE: ELEANOR LOUISE HERTZLER LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCS13964CA

General Provider Information

NPI Number : 1417054214
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELEANOR LOUISE HERTZLER LCSW
Provider Business Mailing Address
First Line : 1475 HUNTINGTON AVE
Second Line : SUITE 201
City : SOUTH SAN FRANCISCO
State : CA
Zip : 94080-5990
Country : US
Telephone Number : 650-873-5825
Fax Number :
Provider Business Practice Location Address
First Line : 1475 HUNTINGTON AVE
Second Line : SUITE 201
City : SOUTH SAN FRANCISCO
State : CA
Zip : 94080-5990
Country : US
Telephone Number : 650-873-5825
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 07/08/2007

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Directions to “ ELEANOR LOUISE HERTZLER LCSW” Practice Location

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