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General NPI Number Information
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NPI Number | 1689889743
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Entity Type | Individual
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Provider Name | MARIA ASCENSION RUNCIMAN MSW
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Gender | Female
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 04/13/2011
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Provider Practice Location Address
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Address Line | 5905 SOQUEL DR STE 650
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City | SOQUEL
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State | CA
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Zip | 95073-2862
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Country | US
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Telephone | 831-728-2494
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Fax | 831-393-3115
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Provider Business Mailing Address
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Address Line | 800 KATIE LN
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City | CORRALITOS
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State | CA
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Zip | 95076-0364
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Country | US
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Telephone | 831-728-2494
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Fax | 831-393-3115
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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 | LCS13446
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License Number State | CA
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