Provider Demographics
NPI:1326196882
Name:JAROSZ, KATHLEEN MARY TERESA (MSW)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:MARY TERESA
Last Name:JAROSZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:
Other - Last Name:JAROSZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:118 AUBURN ST
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-5206
Mailing Address - Country:US
Mailing Address - Phone:415-999-4414
Mailing Address - Fax:415-482-9796
Practice Address - Street 1:1330 LINCOLN AVE STE 310D
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-2120
Practice Address - Country:US
Practice Address - Phone:415-482-9796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW143761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical