Provider Demographics
NPI:1629204219
Name:HORN, WENDY SUE (LCSW)
Entity Type:Individual
Prefix:
First Name:WENDY SUE
Middle Name:
Last Name:HORN
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 1:2425 FILLMORE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1877
Mailing Address - Country:US
Mailing Address - Phone:415-691-7123
Mailing Address - Fax:415-795-4540
Practice Address - Street 1:2425 FILLMORE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-1873
Practice Address - Country:US
Practice Address - Phone:415-691-7123
Practice Address - Fax:415-795-4540
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA279611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical