| S. Van Derwood, Licensed Clinical Social Worker, Inc | |
|
5170 Golden Foothill Pkwy El Dorado Hills CA 95762-9608 | |
| (916) 597-0284 | |
| Not Available |
| Full Name | S. Van Derwood, Licensed Clinical Social Worker, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5170 Golden Foothill Pkwy, El Dorado Hills, California |
| Authorized Official Name and Position | Sharon Lynn Van Derwood (PSYCHOTHERAPIST) |
| Authorized Official Contact | 9165970284 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| S. Van Derwood, Licensed Clinical Social Worker, Inc 5170 Golden Foothill Pkwy El Dorado Hills CA 95762-9608 Ph: (916) 597-0284 | S. Van Derwood, Licensed Clinical Social Worker, Inc 5170 Golden Foothill Pkwy El Dorado Hills CA 95762-9608 Ph: (916) 597-0284 |
| NPI Number | 1508433954 |
|---|---|
| Provider Enumeration Date | 06/04/2021 |
| Last Update Date | 06/04/2021 |
| Certification Date | 06/04/2021 |
| Medicare PECOS PAC ID | 2264839935 |
|---|---|
| Medicare Enrollment ID | O20210922002230 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508433954 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Sharon L Van Derwood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851413272 PECOS PAC ID: 7517364284 Enrollment ID: I20210922002332 |
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