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NPI Code Detail

MEDICARE: ANA VICUNA LCSW

MEDICARE: ANA VICUNA 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
1104100000XSocial WorkerLCS22663CA
21041C0700XClinical Social WorkerLCS22663CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1LCS22663OTHERCABBS

General Provider Information

NPI Number : 1841351913
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANA VICUNA LCSW
Provider Business Mailing Address
First Line : 3299 SESPE CREEK WAY
Second Line :
City : CHICO
State : CA
Zip : 95973-8378
Country : US
Telephone Number : 530-518-3076
Fax Number :
Provider Business Practice Location Address
First Line : 3217 COHASSET RD
Second Line :
City : CHICO
State : CA
Zip : 95973-5404
Country : US
Telephone Number : 530-990-0018
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2006
Last Update Date : 01/27/2021

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Directions to “ ANA VICUNA LCSW” Practice Location

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