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General NPI Number Information
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NPI Number | 1346467974
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Entity Type | Individual
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Provider Name | WENDY LO ASW
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Gender | Female
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2275 ARLINGTON DR
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City | SAN LEANDRO
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State | CA
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Zip | 94578-1132
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Country | US
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Telephone | 510-481-1222
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Fax |
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Provider Business Mailing Address
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Address Line | 15452 HERON DR
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City | SAN LEANDRO
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State | CA
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Zip | 94579-2730
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Country | US
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Telephone | 804-822-1581
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ASW 21512
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License Number State | CA
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