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NPI Code Detail

MEDICARE: MONIQUE MARIN LCSW

MEDICARE: MONIQUE MARIN 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 WorkerLCS 25144CA

General Provider Information

NPI Number : 1952422875
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONIQUE MARIN LCSW
Provider Business Mailing Address
First Line : 137 N COTTONWOOD ST STE 1540
Second Line :
City : WOODLAND
State : CA
Zip : 95695-6664
Country : US
Telephone Number : 530-666-8632
Fax Number :
Provider Business Practice Location Address
First Line : 137 N COTTONWOOD ST STE 1540
Second Line :
City : WOODLAND
State : CA
Zip : 95695-6664
Country : US
Telephone Number : 530-666-8632
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2007
Last Update Date : 03/08/2012

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