Healthcare Provider Details

I. General information

NPI: 1598997504
Provider Name (Legal Business Name): VERONICA CONCEPCION NAVARRO M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2009
Last Update Date: 01/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 EUREKA SQ STE 151
PACIFICA CA
94044-2603
US

IV. Provider business mailing address

PO BOX 1584
PACIFICA CA
94044-6584
US

V. Phone/Fax

Practice location:
  • Phone: 650-228-6153
  • Fax:
Mailing address:
  • Phone: 650-228-6153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number53219
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: