Physician Compare National (NPI:1700110657)

HEALTHCARE PROVIDER: QUEEN ADU-POKU LCSW

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1700110657
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5294058236
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20141229000034
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ADU-POKU
	Individual professional last name
Provider First Name	QUEEN
	Individual professional first name
Provider Middle Name	LYNN MARIE
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2810 LONE TREE WAY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 9
	Group Practice or individual's line 2 address
City	ANTIOCH
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	945094956
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9256289948
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y