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General NPI Number Information
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NPI Number | 1225927809
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Entity Type | Individual
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Provider Name | MR. CLINTON WILLIAM WATSON
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Gender | Male
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 6501 COYLE AVE
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City | CARMICHAEL
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State | CA
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Zip | 95608-0306
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Country | US
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Telephone | 916-537-5291
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Fax |
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Provider Business Mailing Address
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Address Line | 800 J ST UNIT 508
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City | SACRAMENTO
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State | CA
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Zip | 95814-2519
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Country | US
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Telephone | 916-532-9347
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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 | 121850
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License Number State | CA
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