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General NPI Number Information
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NPI Number | 1538812920
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Entity Type | Organization
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Legal Business Name | SOCIAL WORK SUPPORT, INC.
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Dates
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Enumeration Date | 01/27/2022
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Last Update Date | 01/27/2022
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Provider Practice Location Address
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Address Line | 343 E MAIN ST STE 919A
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City | STOCKTON
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State | CA
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Zip | 95202-2932
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Country | US
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Telephone | 415-562-6056
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Fax | 415-952-9565
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Provider Business Mailing Address
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Address Line | 343 E MAIN ST STE 919A
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City | STOCKTON
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State | CA
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Zip | 95202-2932
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Country | US
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Telephone | 415-562-6056
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Fax | 415-952-9565
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BRENDA CORDOVA
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Credential |
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Telephone | 415-562-6056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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