| Within Reach Psychotherapy Lcsw, Inc | |
|
3321 Shelter Creek Ln San Bruno CA 94066-6029 | |
| (510) 833-6074 | |
| Not Available |
| Full Name | Within Reach Psychotherapy Lcsw, Inc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3321 Shelter Creek Ln, San Bruno, California |
| Authorized Official Name and Position | Jorin Bukosky (DIRECTOR) |
| Authorized Official Contact | 5108336074 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Within Reach Psychotherapy Lcsw, Inc 2930 Domingo Ave # 1181 Berkeley CA 94705-2454 Ph: (510) 833-6074 | Within Reach Psychotherapy Lcsw, Inc 3321 Shelter Creek Ln San Bruno CA 94066-6029 Ph: (510) 833-6074 |
| NPI Number | 1033862156 |
|---|---|
| Provider Enumeration Date | 01/28/2022 |
| Last Update Date | 01/28/2022 |
| Certification Date | 01/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033862156 | NPI | - | NPPES |
| 1114334687 | Medicaid | CA | |
| 1790284115 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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