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NPI Code Detail

MEDICARE: DARA MARIE PASTOR LCSW

MEDICARE: DARA MARIE PASTOR 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 Worker
21041C0700XClinical Social Worker101029CA

General Provider Information

NPI Number : 1477000875
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARA MARIE PASTOR LCSW
Provider Business Mailing Address
First Line : 3780 ROSIN CT STE 110
Second Line :
City : SACRAMENTO
State : CA
Zip : 95834-1698
Country : US
Telephone Number : 916-441-0226
Fax Number : 916-441-0286
Provider Business Practice Location Address
First Line : 3780 ROSIN CT STE 110
Second Line :
City : SACRAMENTO
State : CA
Zip : 95834-1698
Country : US
Telephone Number : 916-417-5737
Fax Number : 916-441-6377
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2016
Last Update Date : 08/15/2023

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Directions to “ DARA MARIE PASTOR LCSW” Practice Location

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