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General NPI Number Information
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NPI Number | 1861739906
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Entity Type | Individual
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Provider Name | BECKY R POPOWSKI LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/09/2013
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Last Update Date | 01/09/2013
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Provider Practice Location Address
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Address Line | 2529 W MARCH LN SUITE 203
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City | STOCKTON
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State | CA
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Zip | 95207-8270
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Country | US
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Telephone | 209-403-9669
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Fax |
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Provider Business Mailing Address
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Address Line | 6610 EMBARCADERO DR APT 7
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City | STOCKTON
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State | CA
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Zip | 95219-3348
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Country | US
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Telephone | 209-323-4332
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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 | 26294
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License Number State | CA
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