Basic Information
Provider Information
NPI: 1629124532
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TARANTA
FirstName: ADRIANA
MiddleName: NORSA
NamePrefix: MS.
NameSuffix:  
Credential: L.C.S.W.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2550 23RD ST
Address2: BLDG. 9, RM. 130
City: SAN FRANCISCO
State: CA
PostalCode: 941103504
CountryCode: US
TelephoneNumber: 4152065416
FaxNumber:  
Practice Location
Address1: 1001 POTRERO AVE
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941103518
CountryCode: US
TelephoneNumber: 4152065416
FaxNumber: 4152064722
Other Information
ProviderEnumerationDate: 01/25/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XLCS16881CAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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