Provider Demographics
NPI:1750427381
Name:PACHECO, GUADALUPE (LCSW)
Entity type:Individual
Prefix:MR
First Name:GUADALUPE
Middle Name:
Last Name:PACHECO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:JESSE
Other - Middle Name:
Other - Last Name:PACHECO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4141 GEARY BLVD FL 3
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-3111
Mailing Address - Country:US
Mailing Address - Phone:415-833-2292
Mailing Address - Fax:415-833-4765
Practice Address - Street 1:4141 GEARY BLVD FL 3
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3111
Practice Address - Country:US
Practice Address - Phone:415-833-2292
Practice Address - Fax:415-833-4765
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW21378101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health