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NPI Code Detail

MEDICARE: CHRISTINE ANN CHASE LCSW 125588

MEDICARE: CHRISTINE ANN CHASE LCSW 125588
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
11041C0700XClinical Social Worker089-0001150VT
21041C0700XClinical Social Worker125588CA

General Provider Information

NPI Number : 1174641575
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE ANN CHASE LCSW 125588
Provider Business Mailing Address
First Line : 4205 W FIGARDEN DR
Second Line :
City : FRESNO
State : CA
Zip : 93722-6051
Country : US
Telephone Number : 559-221-1680
Fax Number :
Provider Business Practice Location Address
First Line : 4205 W FIGARDEN DR
Second Line :
City : FRESNO
State : CA
Zip : 93722-6051
Country : US
Telephone Number : 802-488-0051
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2007
Last Update Date : 10/08/2024

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Directions to “ CHRISTINE ANN CHASE LCSW 125588” Practice Location

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