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NPI Code Detail

MEDICARE: MRS. KIRSTIE LYNN MCFADDEN LCSW

MEDICARE: MRS. KIRSTIE LYNN MCFADDEN 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 Worker101441CA

General Provider Information

NPI Number : 1841430907
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIRSTIE LYNN MCFADDEN LCSW
Provider Business Mailing Address
First Line : PO BOX 244
Second Line :
City : BERKELEY
State : CA
Zip : 94701-0244
Country : US
Telephone Number : 510-926-6677
Fax Number : 510-756-0812
Provider Business Practice Location Address
First Line : 235 E BROADWAY STE 314
Second Line :
City : LONG BEACH
State : CA
Zip : 90802-7801
Country : US
Telephone Number : 888-588-8995
Fax Number : 510-756-0812
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2009
Last Update Date : 02/26/2026

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