| Ida Vandaei Lcsw | |
|
4 Embarcadero Ctr Ste 1400 San Francisco CA 94111-4164 | |
| (818) 646-6683 | |
| Not Available |
| Full Name | Ida Vandaei Lcsw |
|---|---|
| Speciality | Counselor |
| Location | 4 Embarcadero Ctr Ste 1400, San Francisco, California |
| Authorized Official Name and Position | Ida Vandaei (PROVIDER) |
| Authorized Official Contact | 8186466683 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ida Vandaei Lcsw 4 Embarcadero Ctr Ste 1400 San Francisco CA 94111-4164 Ph: (818) 646-6683 | Ida Vandaei Lcsw 4 Embarcadero Ctr Ste 1400 San Francisco CA 94111-4164 Ph: (818) 646-6683 |
| NPI Number | 1417429242 |
|---|---|
| Provider Enumeration Date | 12/18/2018 |
| Last Update Date | 11/11/2023 |
| Certification Date | 11/11/2023 |
| Medicare PECOS PAC ID | 4385982719 |
|---|---|
| Medicare Enrollment ID | O20190211001790 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417429242 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Ida Vandaei |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265832604 PECOS PAC ID: 4587962188 Enrollment ID: I20160414002206 |
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