Provider Demographics
NPI:1568972651
Name:ROSSIN, CHLOE (LCSW)
Entity Type:Individual
Prefix:
First Name:CHLOE
Middle Name:
Last Name:ROSSIN
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 1:435 WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-2623
Mailing Address - Country:US
Mailing Address - Phone:650-646-8809
Mailing Address - Fax:
Practice Address - Street 1:220 MONTGOMERY ST STE 1820
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-3468
Practice Address - Country:US
Practice Address - Phone:650-966-2436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW79043101Y00000X
CA1007841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor