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NPI Code Detail

MEDICARE: SUZANNE TEARE LCSW

MEDICARE:   SUZANNE  TEARE  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 Worker121706CA

General Provider Information

NPI Number : 1669094454
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE TEARE LCSW
Provider Business Mailing Address
First Line : 4070 BRIDGE ST STE 5
Second Line :
City : FAIR OAKS
State : CA
Zip : 95628-7557
Country : US
Telephone Number : 916-235-3338
Fax Number :
Provider Business Practice Location Address
First Line : 4070 BRIDGE ST STE 5
Second Line :
City : FAIR OAKS
State : CA
Zip : 95628-7557
Country : US
Telephone Number : 916-234-6581
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2020
Last Update Date : 04/14/2025

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Directions to “ SUZANNE TEARE LCSW” Practice Location

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