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General NPI Number Information
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NPI Number | 1417403064
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Entity Type | Individual
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Provider Name | SUSAN RAUNEGGER LCSW 81670
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Gender | Female
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 04/12/2019
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Provider Practice Location Address
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Address Line | 1360 GROVE CT
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City | SAINT HELENA
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State | CA
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Zip | 94574-1146
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Country | US
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Telephone | 707-292-3126
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Fax |
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Provider Business Mailing Address
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Address Line | 2025 REDWOOD ROAD SUITE 8
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City | ST. HELENA
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State | CA
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Zip | 94574
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Country | US
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Telephone | 707-292-3126
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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 | ASW60335
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License Number State | CA
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