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NPI Code Detail

MEDICARE: MS. MICHELLE ANGELA DECORTE R.N., L.C.S.W.

MEDICARE:  MS. MICHELLE ANGELA DECORTE  R.N., L.C.S.W.
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 WorkerLCS19031CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811946577
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MICHELLE ANGELA DECORTE R.N., L.C.S.W.
Provider Business Mailing Address
First Line : 520 S EL CAMINO REAL
Second Line : SUITE 814
City : SAN MATEO
State : CA
Zip : 94402-1726
Country : US
Telephone Number : 650-483-3845
Fax Number : 650-347-9777
Provider Business Practice Location Address
First Line : 520 S EL CAMINO REAL
Second Line : SUITE 814
City : SAN MATEO
State : CA
Zip : 94402-1726
Country : US
Telephone Number : 650-483-3845
Fax Number : 650-347-9777
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2006
Last Update Date : 05/02/2011

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Directions to “ MS. MICHELLE ANGELA DECORTE R.N., L.C.S.W.” Practice Location

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