Provider Demographics
NPI:1588044903
Name:FRANK, SAMUEL (LCSW, MSW, PPSC)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:FRANK
Suffix:
Gender:M
Credentials:LCSW, MSW, PPSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4348 BROADWAY APT B
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-4602
Mailing Address - Country:US
Mailing Address - Phone:510-463-4968
Mailing Address - Fax:
Practice Address - Street 1:1220 NOE ST.
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-3714
Practice Address - Country:US
Practice Address - Phone:415-695-5675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-01
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA925051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical