Provider Demographics
NPI:1861592453
Name:POPPER, GERRI SULLIVAN (MSW LCSW)
Entity type:Individual
Prefix:MS
First Name:GERRI
Middle Name:SULLIVAN
Last Name:POPPER
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2339 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-2605
Mailing Address - Country:US
Mailing Address - Phone:415-566-1464
Mailing Address - Fax:415-753-5561
Practice Address - Street 1:2339 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94127-2605
Practice Address - Country:US
Practice Address - Phone:415-566-1464
Practice Address - Fax:415-753-5561
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS184051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical