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NPI Code Detail

MEDICARE: MS. MARIE LOURDES SARTE M.A. IN SOCIAL WORK

MEDICARE: MS. MARIE LOURDES SARTE M.A. IN SOCIAL WORK
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 WorkerLCS 23912CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15711OTHERCASTAFF ID NUMBER

General Provider Information

NPI Number : 1205998333
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARIE LOURDES SARTE M.A. IN SOCIAL WORK
Provider Business Mailing Address
First Line : 310 8TH ST STE 201
Second Line :
City : OAKLAND
State : CA
Zip : 94607-6527
Country : US
Telephone Number : 510-869-7207
Fax Number : 510-839-4723
Provider Business Practice Location Address
First Line : 310 8TH ST STE 201
Second Line :
City : OAKLAND
State : CA
Zip : 94607-6527
Country : US
Telephone Number : 510-869-7207
Fax Number : 510-839-4723
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2006
Last Update Date : 08/17/2011

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