Provider Demographics
NPI:1437387610
Name:TEMPLIN, JORDANA ASSAF (MSSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JORDANA
Middle Name:ASSAF
Last Name:TEMPLIN
Suffix:
Gender:F
Credentials:MSSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 CLEMENT ST
Mailing Address - Street 2:(116E)
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-1545
Mailing Address - Country:US
Mailing Address - Phone:415-221-4810
Mailing Address - Fax:415-750-6997
Practice Address - Street 1:4150 CLEMENT ST
Practice Address - Street 2:(116E)
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1545
Practice Address - Country:US
Practice Address - Phone:415-221-4810
Practice Address - Fax:415-750-6997
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA207731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical