Provider Demographics
NPI:1689973588
Name:HOOPER, PAMELA MARIE (LCSW)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:MARIE
Last Name:HOOPER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 EDISON AVE
Mailing Address - Street 2:
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1318
Mailing Address - Country:US
Mailing Address - Phone:415-936-9566
Mailing Address - Fax:
Practice Address - Street 1:60 EDISON AVE
Practice Address - Street 2:
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1318
Practice Address - Country:US
Practice Address - Phone:415-936-9566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID335151041C0700X
CA1223321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical