MEDICARE: BROOKE POMERANTZ 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
1	1041C0700X	Clinical Social Worker	LCS24059	CA

General Provider Information

NPI Number	:	1700072121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE POMERANTZ LCSW

Provider Business Mailing Address
First Line	:	315 MONTGOMERY ST FL 10
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94104-1823
Country	:	US
Telephone Number	:	415-832-0767
Fax Number	:

Provider Business Practice Location Address
First Line	:	315 MONTGOMERY ST FL 10
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94104-1823
Country	:	US
Telephone Number	:	415-832-0767
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2007
Last Update Date	:	08/14/2022

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