Provider Demographics
NPI:1912068685
Name:WEINER, RICK L (LCSW)
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:L
Last Name:WEINER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-1183
Mailing Address - Country:US
Mailing Address - Phone:415-626-7788
Mailing Address - Fax:415-750-1544
Practice Address - Street 1:6221 GEARY BLVD FL 3
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1821
Practice Address - Country:US
Practice Address - Phone:415-626-7788
Practice Address - Fax:415-750-1544
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS141521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical