Healthcare Provider Details

I. General information

NPI: 1659504157
Provider Name (Legal Business Name): ADELAIDE FANDIO NZEUSSEU MSW, PPSC, ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2009
Last Update Date: 08/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1026 OAK GROVE RD
CONCORD CA
94518-3289
US

IV. Provider business mailing address

2730 SALVIO ST
CONCORD CA
94519-2599
US

V. Phone/Fax

Practice location:
  • Phone: 925-682-8000
  • Fax: 925-609-7617
Mailing address:
  • Phone: 925-687-0374
  • Fax: 925-609-7617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: