Healthcare Provider Details

I. General information

NPI: 1669897575
Provider Name (Legal Business Name): PIERRETTE VAN KLEEF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PIA VAN KLEEF LCSW

II. Dates (important events)

Enumeration Date: 02/28/2014
Last Update Date: 06/30/2021
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 ANTELOPE BLVD STE 40A
RED BLUFF CA
96080-2477
US

IV. Provider business mailing address

PO BOX 950
RED BLUFF CA
96080-0950
US

V. Phone/Fax

Practice location:
  • Phone: 530-529-9454
  • Fax: 530-529-9456
Mailing address:
  • Phone: 530-529-9454
  • Fax: 530-529-9456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number28050
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: