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General NPI Number Information
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NPI Number | 1588456974
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Entity Type | Organization
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Legal Business Name | JANESSA RADFORD, LICENSED CLINICAL SOCIAL WORKER, INC.
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Dates
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Enumeration Date | 05/21/2025
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 23 GLEN LAKE DR
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City | PACIFIC GROVE
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State | CA
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Zip | 93950-5372
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Country | US
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Telephone | 925-683-8911
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Fax |
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Provider Business Mailing Address
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Address Line | 225 THE CROSSROADS BLVD STE 262
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City | CARMEL
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State | CA
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Zip | 93923-8674
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JANESSA RADFORD
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Credential | LCSW
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Telephone | 925-683-8911
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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 |
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License Number State |
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