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Individual

ALEXANDER GEOFFREY BLOOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
1030 SIR FRANCIS DRAKE BLVD, KENTFIELD, CA 94904-1411
(152) 467-5224
Mailing address
30 LA PLACITA CT, NOVATO, CA 94945-1244
(510) 331-5744

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW76478
CA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
09/20/2011
Last updated
02/05/2023
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