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General NPI Number Information
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NPI Number | 1154789360
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Entity Type | Individual
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Provider Name | CAROLINE TIMMER
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Gender | Female
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Dates
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Enumeration Date | 02/02/2016
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 3671 BUSINESS DR
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City | SACRAMENTO
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State | CA
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Zip | 95820-2165
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Country | US
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Telephone | 916-734-8396
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Fax |
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Provider Business Mailing Address
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Address Line | 1431 COMMONS DR
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City | SACRAMENTO
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State | CA
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Zip | 95825-6603
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Country | US
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Telephone | 916-524-0408
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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 | 70357
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 94055
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | 94055
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 94055
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License Number State | CA
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