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NPI Code Detail

MEDICARE: MARA STEPHANIE LEON SAMMARTINO LCSW

MEDICARE:   MARA STEPHANIE LEON SAMMARTINO  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 Worker70176CA

General Provider Information

NPI Number : 1861568081
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARA STEPHANIE LEON SAMMARTINO LCSW
Provider Business Mailing Address
First Line : 1000 TEXAS ST STE D
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-5700
Country : US
Telephone Number : 707-639-9158
Fax Number :
Provider Business Practice Location Address
First Line : 607 ELMIRA RD # 355
Second Line :
City : VACAVILLE
State : CA
Zip : 95687-4655
Country : US
Telephone Number : 707-229-1377
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2006
Last Update Date : 09/18/2025

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Directions to “ MARA STEPHANIE LEON SAMMARTINO LCSW” Practice Location

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