Provider Demographics
NPI:1205936317
Name:MOSER, NANCY J (LCSW)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:J
Last Name:MOSER
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 1:3333 CALIFORNIA ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1981
Mailing Address - Country:US
Mailing Address - Phone:415-476-4980
Mailing Address - Fax:415-476-7113
Practice Address - Street 1:3333 CALIFORNIA ST STE 10
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-6200
Practice Address - Country:US
Practice Address - Phone:415-476-4980
Practice Address - Fax:415-476-7113
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA160231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00160230Medicaid
CAP55825Medicare UPIN
CA00160230Medicaid