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NPI Code Detail

MEDICARE: CLARENCE ANTHONY MAPLE

MEDICARE: CLARENCE ANTHONY MAPLE
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
1101Y00000XCounselor
2101Y00000XCounselorASW106160CA
31041C0700XClinical Social WorkerASW106160CA
4101YM0800XMental Health CounselorASW106160CA
5104100000XSocial WorkerASW106160CA

General Provider Information

NPI Number : 1629322334
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLARENCE ANTHONY MAPLE
Provider Business Mailing Address
First Line : 7415 HENRIETTA DR
Second Line :
City : SACRAMENTO
State : CA
Zip : 95822-5142
Country : US
Telephone Number : 916-520-7399
Fax Number : 916-520-7398
Provider Business Practice Location Address
First Line : 7415 HENRIETTA DR
Second Line :
City : SACRAMENTO
State : CA
Zip : 95822-5142
Country : US
Telephone Number : 916-520-7319
Fax Number : 916-737-0262
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2012
Last Update Date : 02/01/2024

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Directions to “ CLARENCE ANTHONY MAPLE ” Practice Location

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