Provider Demographics
NPI:1073012365
Name:ASENCIO-MACMARTIN, ELISENDA EMILIA (LCSW)
Entity Type:Individual
Prefix:
First Name:ELISENDA
Middle Name:EMILIA
Last Name:ASENCIO-MACMARTIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4B GODEUS ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-5005
Mailing Address - Country:US
Mailing Address - Phone:415-845-5334
Mailing Address - Fax:
Practice Address - Street 1:4B GODEUS ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-5005
Practice Address - Country:US
Practice Address - Phone:415-845-5334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-01
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CA1090391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor