Healthcare Provider Details

I. General information

NPI: 1043409774
Provider Name (Legal Business Name): CHARLOTTE MCCALL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHARLOTTE ZELINSKY LCSW

II. Dates (important events)

Enumeration Date: 10/18/2007
Last Update Date: 10/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 MANOR PLZ
PACIFICA CA
94044-1839
US

IV. Provider business mailing address

PO BOX 370547
MONTARA CA
94037-0547
US

V. Phone/Fax

Practice location:
  • Phone: 650-355-8787
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number23550
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: