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NPI Code Detail

MEDICARE: KRISTINA AILEEN SCHLOSSER ACSW, MHRS, MSW

MEDICARE: KRISTINA AILEEN SCHLOSSER ACSW, MHRS, MSW
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 Worker98692CA
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1669702221
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINA AILEEN SCHLOSSER ACSW, MHRS, MSW
Provider Business Mailing Address
First Line : 1821 ALBANY DR
Second Line :
City : SANTA ROSA
State : CA
Zip : 95401-3604
Country : US
Telephone Number : 707-477-9321
Fax Number :
Provider Business Practice Location Address
First Line : 3371 PARKER HILL RD
Second Line :
City : SANTA ROSA
State : CA
Zip : 95404-1732
Country : US
Telephone Number : 707-535-0289
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2010
Last Update Date : 02/02/2024

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