MEDICARE: MS. GLENNA MARTHA AKERS MSW, ACSW

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
1	1041C0700X	Clinical Social Worker	18705	CA

General Provider Information

NPI Number	:	1366777674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GLENNA MARTHA AKERS MSW, ACSW

Provider Business Mailing Address
First Line	:	1698 PARK VISTA DR
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95928-4141
Country	:	US
Telephone Number	:	530-518-7339
Fax Number	:	530-898-4870

Provider Business Practice Location Address
First Line	:	2491 CARMICHAEL DR STE 400
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95928-7191
Country	:	US
Telephone Number	:	530-898-5086
Fax Number	:	530-898-4870

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2009
Last Update Date	:	10/05/2009

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