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General NPI Number Information
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NPI Number | 1720300759
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Entity Type | Organization
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Legal Business Name | CREEKSTONE COUNSELING, LLC
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Dates
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Enumeration Date | 02/18/2010
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Last Update Date | 02/18/2010
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Provider Practice Location Address
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Address Line | 201 SAN ANTONIO CIR SUITE 212
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-1254
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Country | US
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Telephone | 408-722-0522
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Fax | 888-469-5269
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Provider Business Mailing Address
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Address Line | 829 W TAYLOR ST
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City | SAN JOSE
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State | CA
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Zip | 95126-1848
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Country | US
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Telephone | 408-722-0522
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Fax | 888-469-5279
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. ANNETTE F GILBERTSON
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Credential | LCSW
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Telephone | 408-722-0522
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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 | LCS23771
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License Number State | CA
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