Provider Demographics
NPI:1568639136
Name:KOVALSKY, ABBY
Entity Type:Individual
Prefix:MS
First Name:ABBY
Middle Name:
Last Name:KOVALSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 POST ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3508
Mailing Address - Country:US
Mailing Address - Phone:415-449-1224
Mailing Address - Fax:415-449-1253
Practice Address - Street 1:2150 POST ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3508
Practice Address - Country:US
Practice Address - Phone:415-449-1224
Practice Address - Fax:415-449-1253
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS123431041C0700X, 251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ37011ZMedicare PIN