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General NPI Number Information
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NPI Number | 1700078466
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Entity Type | Individual
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Provider Name | CARLA GLINKA
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Gender | Female
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Dates
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Enumeration Date | 08/15/2007
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Last Update Date | 08/15/2007
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Provider Practice Location Address
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Address Line | 1515 S OREGON ST STE. A
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City | YREKA
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State | CA
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Zip | 96097-3425
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Country | US
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Telephone | 530-842-3455
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Fax |
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Provider Business Mailing Address
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Address Line | 1225 UPLAND RD
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City | MOUNT SHASTA
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State | CA
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Zip | 96067-9616
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Country | US
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Telephone | 530-926-0531
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ASW22116
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License Number State | CA
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