Provider Demographics
NPI:1851519490
Name:MACDONALD, YVETTE MARIE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:YVETTE
Middle Name:MARIE
Last Name:MACDONALD
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 1:1008 DE HARO ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-3209
Mailing Address - Country:US
Mailing Address - Phone:415-642-4993
Mailing Address - Fax:
Practice Address - Street 1:610 ELM ST
Practice Address - Street 2:SUITE 212
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-8401
Practice Address - Country:US
Practice Address - Phone:650-367-9687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA219871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical