Rosa Tupina Yaotonalcuauhtli-Orta, LMSW

Individual provider Active NPI Clinical Social Worker · Crockett, CA

NPI 1033319009 · NPPES record last updated Jul 18, 2007

Key facts

NPI
1033319009
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
S24687 (TX)
Practice address
904 5TH Ave
Crockett, CA 94525-1319
Phone
(510) 787-6937
Fax
(510) 787-6937
NPI assigned
Jul 18, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
S24687TXMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X S24687 TX Yes
Community/Behavioral Health Agency 251S00000X S24687 TX

Addresses

Primary practice location

904 5TH Ave
Crockett, CA 94525-1319

Mailing address

904 5TH Ave
Crockett, CA 94525-1319
Phone (510) 787-6937

Other names

  • Mrs. Rosa Maria Valenzuela Former name

Other providers in Crockett, CA

All providers in Crockett, CA · Clinical Social Worker in California

Sources for this page

Verify at the official NPI Registry.