Provider Demographics
NPI:1164300208
Name:KISTLER, MCCALL COURTNEY (ASW)
Entity type:Individual
Prefix:
First Name:MCCALL
Middle Name:COURTNEY
Last Name:KISTLER
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2904 CALIFORNIA ST APT 6
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2451
Mailing Address - Country:US
Mailing Address - Phone:425-218-5774
Mailing Address - Fax:
Practice Address - Street 1:2150 POST ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3508
Practice Address - Country:US
Practice Address - Phone:415-910-1034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW1136281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical