Basic Information
| Provider Information | |||||||||
| NPI: | 1770060733 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PERELMAN | ||||||||
| FirstName: | CLAIRE | ||||||||
| MiddleName: | |||||||||
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| Credential: | ASW | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 3626 BALBOA ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941212604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4156685955 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3626 BALBOA ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941212604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4156685955 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2018 | ||||||||
| LastUpdateDate: | 05/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialNamePrefix: | |||||||||
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| NPICertificationDate: | 05/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 100911 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical | 101Y00000X | 83773 | CA | N | Behavioral Health & Social Service Providers | Counselor |
No ID Information.