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NPI Code Detail

MEDICARE: MS. ANNA WINN

MEDICARE: MS. ANNA WINN
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 22725CA

General Provider Information

NPI Number : 1508089566
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANNA WINN
Provider Business Mailing Address
First Line : 2080 SYLVAN WAY
Second Line : APT #1008
City : LODI
State : CA
Zip : 95242-4487
Country : US
Telephone Number : 209-365-0584
Fax Number : 209-956-4245
Provider Business Practice Location Address
First Line : 6707 EMBARCADERO DR
Second Line :
City : STOCKTON
State : CA
Zip : 95219-3382
Country : US
Telephone Number : 209-956-4240
Fax Number : 209-956-4245
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 07/08/2007

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