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NPI Code Detail

MEDICARE: GLORIALEE FIELDS

MEDICARE:   GLORIALEE  FIELDS
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
1101YM0800XMental Health Counselor
21041C0700XClinical Social Worker107695CA

General Provider Information

NPI Number : 1689856270
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLORIALEE FIELDS
Provider Business Mailing Address
First Line : PO BOX 7401
Second Line :
City : FREMONT
State : CA
Zip : 94537-7401
Country : US
Telephone Number : 925-452-7533
Fax Number :
Provider Business Practice Location Address
First Line : 11501 DUBLIN BLVD STE 200
Second Line :
City : DUBLIN
State : CA
Zip : 94568-2827
Country : US
Telephone Number : 925-452-7533
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2007
Last Update Date : 07/11/2022

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Directions to “ GLORIALEE FIELDS ” Practice Location

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