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General NPI Number Information
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NPI Number | 1063902351
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Entity Type | Individual
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Provider Name | ELA MAZUMDAR MSW
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Gender | Female
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Dates
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Enumeration Date | 05/13/2018
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Last Update Date | 05/04/2023
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Provider Practice Location Address
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Address Line | 4141 HARBOR ST
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City | PITTSBURG
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State | CA
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Zip | 94565-6199
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Country | US
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Telephone | 925-473-2440
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Fax |
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Provider Business Mailing Address
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Address Line | 6775 GOLDEN GATE DR APT 333
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City | DUBLIN
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State | CA
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Zip | 94568-4377
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Country | US
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Telephone | 925-286-8124
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 103786
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License Number State | CA
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