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General NPI Number Information
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NPI Number | 1861259319
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Entity Type | Individual
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Provider Name | KIRSTEN MARIE TOWNE ASW
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Gender | Female
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Dates
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Enumeration Date | 03/01/2024
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Last Update Date | 03/01/2024
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Provider Practice Location Address
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Address Line | 277 SOUTH ST STE W
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-5058
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Country | US
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Telephone | 805-503-5783
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Fax |
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Provider Business Mailing Address
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Address Line | 277 SOUTH ST STE W
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-5058
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Country | US
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Telephone | 805-503-5783
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Fax | 805-782-8711
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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 | 119462
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License Number State | CA
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