Kristina Woodward Mackie, MSW, LCSW | |
5330 San Bernardino St, Montclair, CA 91763-2952 | |
(909) 399-3751 | |
Not Available |
Full Name | Kristina Woodward Mackie |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 5330 San Bernardino St, Montclair, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780870998 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | ASW 22155 (California) | Secondary |
1041C0700X | Social Worker - Clinical | LCSW #27104 (California) | Primary |
Entity Name | Southern California Permanente Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823 |
Mailing Address | Practice Location Address |
---|---|
Kristina Woodward Mackie, MSW, LCSW 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739-9662 Ph: (909) 463-5234 | Kristina Woodward Mackie, MSW, LCSW 5330 San Bernardino St, Montclair, CA 91763-2952 Ph: (909) 399-3751 |
Sarah Claire Diebold, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 9916 Central Ave, Montclair, CA 91763 Phone: 909-450-2502 | |
Rosa Maria Ocegueda, ASW73155 Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5050 Palo Verde St, Montclair, CA 91763 Phone: 909-766-0096 | |
Mr. David Rodriguez, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5330 San Bernardino St, Montclair, CA 91763 Phone: 909-399-3737 Fax: 909-399-3750 | |
Mrs. Karen R Nembhard Duran, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5206 Benito St Ste 201, Montclair, CA 91763 Phone: 909-764-8629 Fax: 800-418-1965 | |
Mrs. Morgan Rochelle Stokes, CLINICAL SOCIAL WORK Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5050 San Bernardino St, Montclair, CA 91763 Phone: 909-281-5800 | |
Elisa Veronica Lopez-garcia, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 9916 Central Ave, Montclair, CA 91763 Phone: 909-450-2502 |