Provider Demographics
NPI:1912073842
Name:CHAN, PAULINE SH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PAULINE
Middle Name:SH
Last Name:CHAN
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 1:4141 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:
Mailing Address - Fax:
Practice Address - Street 1:4141 GEARY BLVD.
Practice Address - Street 2:3RD FLOOR DEPARTMENT OF PSYCHIATRY
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118
Practice Address - Country:US
Practice Address - Phone:415-833-2292
Practice Address - Fax:415-833-2248
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 189031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical