Provider Demographics
NPI:1487835823
Name:SUNIEWICK, ETHAN
Entity Type:Individual
Prefix:MR
First Name:ETHAN
Middle Name:
Last Name:SUNIEWICK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2525
Mailing Address - Country:US
Mailing Address - Phone:415-335-8300
Mailing Address - Fax:415-861-5395
Practice Address - Street 1:1520 HOWARD ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2525
Practice Address - Country:US
Practice Address - Phone:415-335-8300
Practice Address - Fax:415-861-5395
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker