MEDICARE: MARIA G. CASAS 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	ASW 16644	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ASW 16644	OTHER	CA	CLINICAL SOCIAL WORKER

General Provider Information

NPI Number	:	1861477572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA G. CASAS LCSW

Provider Business Mailing Address
First Line	:	1 QUALITY DR
Second Line	:
City	:	VACAVILLE
State	:	CA
Zip	:	95688-9494
Country	:	US
Telephone Number	:	707-624-3020
Fax Number	:	707-624-3045

Provider Business Practice Location Address
First Line	:	1 QUALITY DR
Second Line	:
City	:	VACAVILLE
State	:	CA
Zip	:	95688-9494
Country	:	US
Telephone Number	:	707-624-3020
Fax Number	:	707-624-3020

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

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	12/30/2021

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