Healthcare Provider Details

I. General information

NPI: 1700372257
Provider Name (Legal Business Name): CAROLYNN MAUREEN SKIRO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROLYNN MAUREEN LITTLEFORD

II. Dates (important events)

Enumeration Date: 07/09/2018
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10535 HOSPITAL WAY
MATHER CA
95655-4200
US

IV. Provider business mailing address

240 NATOMA STATION DR APT 119
FOLSOM CA
95630-7981
US

V. Phone/Fax

Practice location:
  • Phone: 916-843-2907
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC012874
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number11773
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number123603
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: