Basic Information
| Provider Information | |||||||||
| NPI: | 1528185196 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NG | ||||||||
| FirstName: | VIOLET | ||||||||
| MiddleName: | W | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1520 STOCKTON ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941333354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4153919686 | ||||||||
| FaxNumber: | 4152922030 | ||||||||
| Practice Location | |||||||||
| Address1: | 1520 STOCKTON ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941333354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4153919686 | ||||||||
| FaxNumber: | 4152922030 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2007 | ||||||||
| LastUpdateDate: | 02/22/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LCS13417 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 620 | 01 | SFGH INTERNAL USE ONLY | OTHER | 620 | 01 | CBHS INTERNAL USE ONLY-COMMERCIAL NUMBER | OTHER |