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NPI 1336710409

NPI 1336710409 : RAVEN FINSTAD-SPLETZER : RIVERSIDE, CA

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General NPI Number Information
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    NPI Number           |    1336710409
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    Entity Type          |    Individual 
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    Provider Name        |    RAVEN FINSTAD-SPLETZER
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/08/2021
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    Last Update Date     |    10/13/2023
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Provider Practice Location Address
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    Address Line         |    2085 RUSTIN AVE 
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    City                 |    RIVERSIDE
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    State                |    CA
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    Zip                  |    92507-2498
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    Country              |    US
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    Telephone            |    951-944-7157
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    525 TECHNOLOGY CT STE 105 
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    City                 |    RIVERSIDE
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    State                |    CA
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    Zip                  |    92507-2181
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    Country              |    US
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    Telephone            |    951-394-1367
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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        |    171M00000X
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    Taxonomy Name        |    Case Manager/Care Coordinator
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    108576
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    License Number State |    CA
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