Provider Demographics
NPI:1952599896
Name:EICHENBAUM, JEANNA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JEANNA
Middle Name:
Last Name:EICHENBAUM
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 1:870 MARKET ST STE 461
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-3011
Mailing Address - Country:US
Mailing Address - Phone:415-318-9584
Mailing Address - Fax:
Practice Address - Street 1:870 MARKET ST STE 461
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3011
Practice Address - Country:US
Practice Address - Phone:415-318-9584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS147621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical