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NPI Code Detail

MEDICARE: MONICA PECK M.S.W., LCSW#26360

MEDICARE: MONICA PECK M.S.W., LCSW#26360
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 WorkerLCSW26360CA
21041C0700XClinical Social Worker26360CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11861716490OTHERNPI

General Provider Information

NPI Number : 1861716490
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONICA PECK M.S.W., LCSW#26360
Provider Business Mailing Address
First Line : 3838 SAN DIMAS ST
Second Line : STE A100
City : BAKERSFIELD
State : CA
Zip : 93301-2286
Country : US
Telephone Number : 661-377-2250
Fax Number : 661-327-5432
Provider Business Practice Location Address
First Line : 3838 SAN DIMAS ST
Second Line : STE A100
City : BAKERSFIELD
State : CA
Zip : 93301-2286
Country : US
Telephone Number : 661-377-2250
Fax Number : 661-327-5432
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2010
Last Update Date : 07/16/2019

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Directions to “ MONICA PECK M.S.W., LCSW#26360” Practice Location

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