Healthcare Provider Details

I. General information

NPI: 1508910076
Provider Name (Legal Business Name): NANCY METCALF LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 08/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 E F ST
TEHACHAPI CA
93561-1710
US

IV. Provider business mailing address

113 E F ST
TEHACHAPI CA
93561-1710
US

V. Phone/Fax

Practice location:
  • Phone: 661-822-8223
  • Fax:
Mailing address:
  • Phone: 661-822-8223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS19924
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: