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NPI Code Detail

MEDICARE: VETERANS ADMINISTRATION

MEDICARE: VETERANS ADMINISTRATION
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 WorkerLCS 22073CA

General Provider Information

NPI Number : 1356458830
Entity Type Code : Organization
Provider Name (Legal Business Name) : VETERANS ADMINISTRATION
Provider Business Mailing Address
First Line : PO BOX 304
Second Line :
City : NOVATO
State : CA
Zip : 94948-0304
Country : US
Telephone Number : 707-562-8209
Fax Number :
Provider Business Practice Location Address
First Line : 201 WALNUT AVE
Second Line :
City : VALLEJO
State : CA
Zip : 94592-1107
Country : US
Telephone Number : 707-562-8209
Fax Number :
Authorized Official
Title or Position : MENTAL HEALTH SOCIAL WORKER
Name : MS. DEBRA NATHANSON
Credential : LCSW
Telephone Number : 707-562-8209
Provider Enumeration Date : 08/23/2006
Last Update Date : 08/05/2008

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Directions to “VETERANS ADMINISTRATION ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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