Provider Demographics
NPI:1578770301
Name:PARZEN, ELINOR (ELLIE) MOSS (LCSW)
Entity Type:Individual
Prefix:
First Name:ELINOR (ELLIE)
Middle Name:MOSS
Last Name:PARZEN
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 1:520 TOWNSEND ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-4918
Mailing Address - Country:US
Mailing Address - Phone:415-217-3292
Mailing Address - Fax:
Practice Address - Street 1:520 TOWNSEND ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-4918
Practice Address - Country:US
Practice Address - Phone:415-217-3292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL.C.S.149101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABIS 1465Medicare ID - Type UnspecifiedMENTAL HEALTH MEDI CAL