Healthcare Provider Details

I. General information

NPI: 1659462653
Provider Name (Legal Business Name): STEVEN MICHAEL BOYD M.S.W.; L.C.S.W.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 JEFFERSON ST #600A
NAPA CA
94559-2442
US

IV. Provider business mailing address

1303 JEFFERSON ST #600A
NAPA CA
94559-2442
US

V. Phone/Fax

Practice location:
  • Phone: 707-259-1175
  • Fax: 707-255-3715
Mailing address:
  • Phone: 707-259-1175
  • Fax: 707-255-3715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS 17792
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: