Provider Demographics
NPI:1144464868
Name:KRASNER, PAMELA BETH (MSW)
Entity type:Individual
Prefix:MISS
First Name:PAMELA
Middle Name:BETH
Last Name:KRASNER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 ELM ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-8401
Mailing Address - Country:US
Mailing Address - Phone:650-579-0361
Mailing Address - Fax:650-342-6727
Practice Address - Street 1:610 ELM ST
Practice Address - Street 2:SUITE 212
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-8401
Practice Address - Country:US
Practice Address - Phone:650-579-0361
Practice Address - Fax:650-342-6727
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 195891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical