Provider Demographics
NPI:1942424973
Name:SHASKAN, GEOFFREY WILLIAM (LCSW)
Entity Type:Individual
Prefix:MR
First Name:GEOFFREY
Middle Name:WILLIAM
Last Name:SHASKAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 LAUREL ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1951
Mailing Address - Country:US
Mailing Address - Phone:415-747-6761
Mailing Address - Fax:
Practice Address - Street 1:399 LAUREL ST
Practice Address - Street 2:SUITE 1
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1951
Practice Address - Country:US
Practice Address - Phone:415-747-6761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS045651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ28294ZMedicare ID - Type Unspecified