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NPI Code Detail

MEDICARE: DONNISE POWELL

MEDICARE: DONNISE POWELL
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 WorkerCSW007544GA

General Provider Information

NPI Number : 1225556988
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONNISE POWELL
Provider Business Mailing Address
First Line : 7 CRYSTAL GATE CMNS
Second Line :
City : HAYWARD
State : CA
Zip : 94544-1369
Country : US
Telephone Number : 510-552-7457
Fax Number :
Provider Business Practice Location Address
First Line : 313 W WINTON AVE
Second Line :
City : HAYWARD
State : CA
Zip : 94544-1136
Country : US
Telephone Number : 510-552-7457
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2017
Last Update Date : 05/13/2024

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