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General NPI Number Information
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NPI Number | 1699406280
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Entity Type | Individual
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Provider Name | MICHAEL LUIS RAZO-NAVARRETE
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Gender | Male
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Dates
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Enumeration Date | 06/23/2022
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Last Update Date | 11/02/2026
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Provider Practice Location Address
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Address Line | 2420 MARTIN RD STE 200
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City | FAIRFIELD
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State | CA
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Zip | 94534-8610
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Country | US
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Telephone | 707-428-4198
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Fax |
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Provider Business Mailing Address
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Address Line | 183 AEGEAN WAY APT 31
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City | VACAVILLE
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State | CA
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Zip | 95687-4022
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Country | US
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Telephone | 408-960-4282
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | ASW139454
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License Number State | CA
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