Provider Demographics
NPI:1124336565
Name:REIJERSE, ERICK F (LCSW)
Entity type:Individual
Prefix:MR
First Name:ERICK
Middle Name:F
Last Name:REIJERSE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-1235
Mailing Address - Country:US
Mailing Address - Phone:415-836-1700
Mailing Address - Fax:415-836-1737
Practice Address - Street 1:555 POLK ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3333
Practice Address - Country:US
Practice Address - Phone:628-217-6432
Practice Address - Fax:415-292-2030
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-20
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA817291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA81729OtherLCSW