MEDICARE: NORMAN PLOTKIN CHT

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1417554007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NORMAN PLOTKIN CHT

Provider Business Mailing Address
First Line	:	717 K ST STE 430
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95814-3477
Country	:	US
Telephone Number	:	916-400-9885
Fax Number	:

Provider Business Practice Location Address
First Line	:	717 K ST STE 430
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95814-3477
Country	:	US
Telephone Number	:	916-400-9885
Fax Number	:

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

Provider Enumeration Date	:	10/06/2020
Last Update Date	:	10/06/2020

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