Provider Demographics
NPI:1750706768
Name:JOSEPH, STEPHANO (ACSW)
Entity type:Individual
Prefix:
First Name:STEPHANO
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2017 MISSION ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-1296
Mailing Address - Country:US
Mailing Address - Phone:415-715-1050
Mailing Address - Fax:415-715-1051
Practice Address - Street 1:2017 MISSION ST FL 2
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-1296
Practice Address - Country:US
Practice Address - Phone:415-715-1050
Practice Address - Fax:415-715-1051
Is Sole Proprietor?:No
Enumeration Date:2014-02-27
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32210101Y00000X, 101YM0800X
CA817481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health