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General NPI Number Information
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NPI Number | 1649485442
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Entity Type | Individual
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Provider Name | CAROLYN MAY GUADAGNOLO LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4501 X ST
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City | SACRAMENTO
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State | CA
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Zip | 95817-2229
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Country | US
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Telephone | 916-734-8299
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Fax | 916-734-5811
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Provider Business Mailing Address
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Address Line | 3240 SHASTA WAY
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City | SACRAMENTO
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State | CA
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Zip | 95821-3432
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Country | US
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Telephone | 916-734-8299
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Fax | 916-734-5811
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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 | LCS11590
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License Number State | CA
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