Provider Demographics
NPI:1205156726
Name:BLUNCK, SUSANNE
Entity type:Individual
Prefix:MS
First Name:SUSANNE
Middle Name:
Last Name:BLUNCK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:SUSANNE
Other - Middle Name:
Other - Last Name:WU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:368 FELL ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5144
Mailing Address - Country:US
Mailing Address - Phone:415-861-0828
Mailing Address - Fax:415-861-0257
Practice Address - Street 1:2481 HARRISON ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2710
Practice Address - Country:US
Practice Address - Phone:415-285-8100
Practice Address - Fax:415-285-2448
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor