MEDICARE: MRS. NANCY RUTH BELKNAP CAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	01-052996	CA

General Provider Information

NPI Number	:	1043691256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NANCY RUTH BELKNAP CAS

Provider Business Mailing Address
First Line	:	5444 EL CARRO LANE
Second Line	:
City	:	CARPINTERIA
State	:	CA
Zip	:	93013
Country	:	US
Telephone Number	:	805-729-2118
Fax Number	:

Provider Business Practice Location Address
First Line	:	5444 EL CARRO LN
Second Line	:
City	:	CARPINTERIA
State	:	CA
Zip	:	93013-1543
Country	:	US
Telephone Number	:	805-729-2118
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2015
Last Update Date	:	06/12/2015

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