Provider Demographics
NPI:1588033062
Name:BEDAK, JEANETTE NAOMI
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:NAOMI
Last Name:BEDAK
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 1:890 HAYES ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-2615
Mailing Address - Country:US
Mailing Address - Phone:415-701-5100
Mailing Address - Fax:415-621-1033
Practice Address - Street 1:890 HAYES STREET
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117
Practice Address - Country:US
Practice Address - Phone:415-701-5100
Practice Address - Fax:415-621-1033
Is Sole Proprietor?:No
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor