Healthcare Provider Details

I. General information

NPI: 1083987614
Provider Name (Legal Business Name): KEIR CALVERT MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2012
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 HIGH ST. 118B
AUBURN CA
95603-5043
US

IV. Provider business mailing address

1230 HIGH ST. 118B
AUBURN CA
95603-5043
US

V. Phone/Fax

Practice location:
  • Phone: 530-401-6846
  • Fax:
Mailing address:
  • Phone: 530-401-6846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number76429
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: