Provider Demographics
NPI:1942595764
Name:VALENTINE, ANN LARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:LARIE
Last Name:VALENTINE
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 1:4148 24TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-3615
Mailing Address - Country:US
Mailing Address - Phone:415-515-8374
Mailing Address - Fax:415-550-8666
Practice Address - Street 1:4148 24TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-3615
Practice Address - Country:US
Practice Address - Phone:415-515-8374
Practice Address - Fax:415-550-8666
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS241601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical