Amalia Maya Lastra, | |
800 Scenic Dr, Modesto, CA 95350-6131 | |
(209) 605-5543 | |
Not Available |
Full Name | Amalia Maya Lastra |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 800 Scenic Dr, Modesto, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1871001024 | NPI | - | NPPES |
Entity Name | Permanente Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
Mailing Address | Practice Location Address |
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Amalia Maya Lastra, Po Box 1859, Modesto, CA 95353-1859 Ph: () - | Amalia Maya Lastra, 800 Scenic Dr, Modesto, CA 95350-6131 Ph: (209) 605-5543 |
Leticia Gomez, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1604 Ford Ave Ste 9, Modesto, CA 95350 Phone: 209-353-2522 | |
Mr. William Leon Boddie Ii, L.C.S.W Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1524 Mchenry Ave, Suite # 450, Modesto, CA 95350 Phone: 209-557-6217 Fax: 209-557-9032 | |
Diana Faith Kigenyi, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1225 Oakdale Road, Modesto, CA 95355 Phone: 209-557-6200 | |
Ms. Shamerin Bourang, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1225 Oakdale Rd, Modesto, CA 95355 Phone: 209-557-6213 | |
Mrs. Maria Edith Martinez, MSW,ASW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2000 W Briggsmore Ave Ste I, Modesto, CA 95350 Phone: 209-526-1476 | |
Paul Samuel Crenshaw, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 726 14th St Ste A, Modesto, CA 95354 Phone: 209-614-1440 | |
Erika Navarro, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1866 Maria Ct, Modesto, CA 95354 Phone: 209-531-4268 |