Provider Demographics
NPI:1124161724
Name:MACHOLD, DEBORAH K (LCSW)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:K
Last Name:MACHOLD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 GUERRERO ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-1015
Mailing Address - Country:US
Mailing Address - Phone:415-503-1735
Mailing Address - Fax:415-520-0838
Practice Address - Street 1:450 GUERRERO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-1015
Practice Address - Country:US
Practice Address - Phone:415-503-1735
Practice Address - Fax:415-520-0838
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS242691041C0700X
CAASW 159421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical