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NPI Code Detail

MEDICARE: MRS. BRENDA MARIE STORY LCSW

MEDICARE: MRS. BRENDA MARIE STORY 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
1104100000XSocial Worker64809CA
21041C0700XClinical Social Worker64809CA

General Provider Information

NPI Number : 1184751000
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRENDA MARIE STORY LCSW
Provider Business Mailing Address
First Line : PO BOX 81252
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93380-1252
Country : US
Telephone Number : 661-426-6772
Fax Number : 866-292-0205
Provider Business Practice Location Address
First Line : 3300 TRUXTUN AVE STE 100
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93301-3123
Country : US
Telephone Number : 661-868-6465
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2007
Last Update Date : 02/26/2021

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