Staci Louise Altomare, LCSW
Individual provider Active NPI Social Worker · Eureka, CA
NPI 1053712372 · NPPES record last updated Mar 21, 2024
Key facts
- NPI
- 1053712372
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- LCSW114922 (CA)
- Practice address
- 720 Wood St
Eureka, CA 95501-4413 - Phone
- (707) 268-2990
- NPI assigned
- Sep 5, 2014
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW114922 | CA | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LCSW114922 | CA | |
| Counselor | 101Y00000X | |||
| Clinical Social Worker | 1041C0700X | LCSW114922 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Social Worker | 104100000X | LCSW114922 | CA | Yes |
Addresses
Primary practice location
720 Wood St
Eureka, CA 95501-4413
Mailing address
720 Wood St
Eureka, CA 95501-4413
Phone (707) 268-2990
Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.