Healthcare Provider Details

I. General information

NPI: 1245310184
Provider Name (Legal Business Name): ANNE L. BERNER CALDERWOOD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 03/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 SCOTT STREET THE COTTAGE
MURPHYS CA
95247-2244
US

IV. Provider business mailing address

PO BOX 2244
MURPHYS CA
95247-2244
US

V. Phone/Fax

Practice location:
  • Phone: 209-728-1250
  • Fax: 209-728-2037
Mailing address:
  • Phone: 209-728-1250
  • Fax: 209-728-2037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS11816
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: