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NPI Code Detail

MEDICARE: MR. EDWARD D. CABANNE MSW LCSW

MEDICARE: MR. EDWARD D. CABANNE MSW LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker23359CA

General Provider Information

NPI Number : 1063436871
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EDWARD D. CABANNE MSW LCSW
Provider Business Mailing Address
First Line : 3179 STARDUST ST
Second Line :
City : ROCKLIN
State : CA
Zip : 95677-1725
Country : US
Telephone Number : 916-630-0289
Fax Number :
Provider Business Practice Location Address
First Line : 855 HOWE AVE
Second Line : SUITE 1
City : SACRAMENTO
State : CA
Zip : 95825-3912
Country : US
Telephone Number : 916-929-0808
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 07/08/2007

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