Individual
MR. JONATHAN JOSEPH BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
170 S SPRUCE AVE STE 200, SOUTH SAN FRANCISCO, CA 94080-4557
(650) 517-8220
Mailing address
170 S SPRUCE AVE STE 200, SOUTH SAN FRANCISCO, CA 94080-4557
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
ASW113373
CA
Other
Enumeration date
05/11/2023
Last updated
05/11/2023
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