| The Practice Counseling Services Licensed Clinical Social Worker, Pc | |
|
1000 Texas St Ste D Fairfield CA 94533 | |
| (562) 587-7409 | |
| Not Available |
| Full Name | The Practice Counseling Services Licensed Clinical Social Worker, Pc |
|---|---|
| Speciality | Social Worker |
| Location | 1000 Texas St Ste D, Fairfield, California |
| Authorized Official Name and Position | Mara Sammartino (OFFICE MANAGER) |
| Authorized Official Contact | 5625877409 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Practice Counseling Services Licensed Clinical Social Worker, Pc 1000 Texas St Ste D Fairfield CA 94533-5700 Ph: (562) 587-7409 | The Practice Counseling Services Licensed Clinical Social Worker, Pc 1000 Texas St Ste D Fairfield CA 94533 Ph: (562) 587-7409 |
| NPI Number | 1831692573 |
|---|---|
| Provider Enumeration Date | 03/08/2018 |
| Last Update Date | 07/06/2018 |
| Medicare PECOS PAC ID | 4587929427 |
|---|---|
| Medicare Enrollment ID | O20180524002479 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831692573 | NPI | - | NPPES |
| Provider Name | Audrey N Reyes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215440656 PECOS PAC ID: 3577828417 Enrollment ID: I20180719001421 |
| Provider Name | Jennifer M Lovelace |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932564333 PECOS PAC ID: 1759646698 Enrollment ID: I20180813003223 |
| Provider Name | Mara Stephanie Leon Sammartino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861568081 PECOS PAC ID: 4486919321 Enrollment ID: I20190809000415 |
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