MEDICARE: MS. NAN SENZAKI LCSW

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	1041C0700X	Clinical Social Worker	LCS9579	CA

General Provider Information

NPI Number	:	1336308899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NAN SENZAKI LCSW

Provider Business Mailing Address
First Line	:	ONE SHIELDS AVE
Second Line	:	219 NORTH HALL CAPS UC DAVIS
City	:	DAVIS
State	:	CA
Zip	:	95616-5270
Country	:	US
Telephone Number	:	530-752-0871
Fax Number	:

Provider Business Practice Location Address
First Line	:	ONE SHIELDS AVE
Second Line	:	219 NORTH HALL CAPS UC DAVIS
City	:	DAVIS
State	:	CA
Zip	:	95616-5270
Country	:	US
Telephone Number	:	530-752-0871
Fax Number	:

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

Provider Enumeration Date	:	06/09/2008
Last Update Date	:	06/09/2008

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