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General NPI Number Information
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NPI Number | 1922942929
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Entity Type | Organization
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Legal Business Name | BIANCA JARVIS, LCSW A LICENSED CLINICAL SOCIAL WORKER CORP, INC.
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Dates
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Enumeration Date | 04/18/2026
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Last Update Date | 04/18/2026
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Provider Practice Location Address
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Address Line | 3397 MT DIABLO BLVD STE E
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City | LAFAYETTE
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State | CA
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Zip | 94549-4018
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Country | US
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Telephone | 510-214-2470
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5041
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City | BERKELEY
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State | CA
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Zip | 94705-0041
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO, CFO, SECRETARY
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Name | BIANCA JARVIS
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Credential |
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Telephone | 510-214-2470
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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 |
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License Number State |
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