Healthcare Provider Details

I. General information

NPI: 1407298037
Provider Name (Legal Business Name): NEISHA FURTADO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2013
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 MISSION SIERRA CT APT 2
REDDING CA
96003-3870
US

IV. Provider business mailing address

870 MISSION SIERRA CT APT 2
REDDING CA
96003-3870
US

V. Phone/Fax

Practice location:
  • Phone: 530-518-5625
  • Fax:
Mailing address:
  • Phone: 530-518-5625
  • Fax: 530-225-7961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number115331
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: