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NPI Code Detail

MEDICARE: PATRICIA C POBLETE LCSW

MEDICARE: PATRICIA C POBLETE 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 Worker27602CA
21041C0700XClinical Social Worker8784-CNV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
127602OTHERCABBS
28784-COTHERNVSTATE OF NEVADA BOARD OF EXAMINERS FOR SOCIAL WORKERS

General Provider Information

NPI Number : 1356490684
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA C POBLETE LCSW
Provider Business Mailing Address
First Line : 1930 VILLAGE CENTER CIR # 3239
Second Line :
City : LAS VEGAS
State : NV
Zip : 89134-6299
Country : US
Telephone Number : 510-224-0103
Fax Number :
Provider Business Practice Location Address
First Line : 1809 SNOW SPRING LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89134-2551
Country : US
Telephone Number : 725-270-7759
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2007
Last Update Date : 10/22/2022

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Directions to “ PATRICIA C POBLETE LCSW” Practice Location

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