Individual
MRS. JEANETTE KADESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1214 LINCOLN AVE, SAN RAFAEL, CA 94901-3230
(415) 721-1720
(415) 472-3829
Mailing address
1214 LINCOLN AVE, SAN RAFAEL, CA 94901
(415) 721-1720
(415) 472-3829
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCS15739
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6201349
UBH
CA
01
—
LCS157390
BLUE SHIELD
CA
01
—
MHN231723
GEHA CA
CA
Enumeration date
02/23/2007
Last updated
07/08/2007
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