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NPI Code Detail

MEDICARE: MRS. ALICE THOMPSON SLAUGHTER ASW

MEDICARE: MRS. ALICE THOMPSON SLAUGHTER ASW
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 WorkerLES12349CA

General Provider Information

NPI Number : 1669676359
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ALICE THOMPSON SLAUGHTER ASW
Provider Business Mailing Address
First Line : 111 MYRTLE ST
Second Line : SUITE 102
City : OAKLAND
State : CA
Zip : 94607-2525
Country : US
Telephone Number : 510-759-7677
Fax Number :
Provider Business Practice Location Address
First Line : 111 MYRTLE ST
Second Line : SUITE 102
City : OAKLAND
State : CA
Zip : 94607-2525
Country : US
Telephone Number : 510-759-7677
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2007
Last Update Date : 12/30/2021

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