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NPI Code Detail

MEDICARE: MRS. JEANNETTE ANNE ADAMSKI-CHURCH CSP II

MEDICARE: MRS. JEANNETTE ANNE ADAMSKI-CHURCH CSP II
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

General Provider Information

NPI Number : 1720110489
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JEANNETTE ANNE ADAMSKI-CHURCH CSP II
Provider Business Mailing Address
First Line : 3565 ALPINE LN
Second Line :
City : LOOMIS
State : CA
Zip : 95650-9039
Country : US
Telephone Number : 916-787-8979
Fax Number : 916-787-8989
Provider Business Practice Location Address
First Line : 101 CIRBY HILLS DR
Second Line : SUITE 5
City : ROSEVILLE
State : CA
Zip : 95678-4360
Country : US
Telephone Number : 916-787-8979
Fax Number : 916-787-8989
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2007
Last Update Date : 07/08/2007

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