| Chaparral Counseling, Licensed Clinical Social Worker, Pc | |
|
2100 Lakeshore Ave Ste C Oakland CA 94606-1188 | |
| (510) 971-0799 | |
| Not Available |
| Full Name | Chaparral Counseling, Licensed Clinical Social Worker, Pc |
|---|---|
| Speciality | Social Worker |
| Location | 2100 Lakeshore Ave Ste C, Oakland, California |
| Authorized Official Name and Position | Fiona C. Lundy (PRESIDENT) |
| Authorized Official Contact | 5109710799 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chaparral Counseling, Licensed Clinical Social Worker, Pc 2100 Lakeshore Ave Ste C Oakland CA 94606-1188 Ph: (510) 971-0799 | Chaparral Counseling, Licensed Clinical Social Worker, Pc 2100 Lakeshore Ave Ste C Oakland CA 94606-1188 Ph: (510) 971-0799 |
| NPI Number | 1003576224 |
|---|---|
| Provider Enumeration Date | 12/29/2021 |
| Last Update Date | 12/29/2021 |
| Certification Date | 12/29/2021 |
| Medicare PECOS PAC ID | 5890189039 |
|---|---|
| Medicare Enrollment ID | O20220303001557 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003576224 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Fiona Camille Lundy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598198350 PECOS PAC ID: 8123353844 Enrollment ID: I20190717001168 |
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