Provider Demographics
NPI:1285201707
Name:CALCOTE, TIFFANI SIMONE (LCSW)
Entity type:Individual
Prefix:
First Name:TIFFANI
Middle Name:SIMONE
Last Name:CALCOTE
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:PO BOX 451403
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-8515
Mailing Address - Country:US
Mailing Address - Phone:213-464-4377
Mailing Address - Fax:
Practice Address - Street 1:625 MARKET ST FL 15
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-3316
Practice Address - Country:US
Practice Address - Phone:415-360-3833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-04
Last Update Date:2023-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW996561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical