Provider Demographics
NPI:1366779183
Name:HONMA, KRISTEN JAYE (LCSW)
Entity type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:JAYE
Last Name:HONMA
Suffix:
Gender:F
Credentials:LCSW
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:375 WOODSIDE AVE
Mailing Address - Street 2:SPY MEDICAL CLINIC
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-1221
Mailing Address - Country:US
Mailing Address - Phone:415-753-7773
Mailing Address - Fax:415-753-7822
Practice Address - Street 1:375 WOODSIDE AVE
Practice Address - Street 2:SPY MEDICAL CLINIC
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94127-1221
Practice Address - Country:US
Practice Address - Phone:415-753-7773
Practice Address - Fax:415-753-7822
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-16
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA297081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical