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NPI Code Detail

MEDICARE: MARY LOIS COMESKEY

MEDICARE: MARY LOIS COMESKEY
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 WorkerLCS4648CA

General Provider Information

NPI Number : 1063630432
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY LOIS COMESKEY
Provider Business Mailing Address
First Line : 22838 EAST CLIFF DRIVE
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95062
Country : US
Telephone Number : 831-477-0215
Fax Number :
Provider Business Practice Location Address
First Line : 4850 UNION AVENUE
Second Line :
City : SAN JOSE
State : CA
Zip : 95124-5156
Country : US
Telephone Number : 408-559-5600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2007
Last Update Date : 07/08/2007

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Directions to “ MARY LOIS COMESKEY ” Practice Location

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