Charmaine Green
Individual provider Active NPI Counselor · Pacifica, CA
NPI 1104358233 · NPPES record last updated Mar 29, 2017
Key facts
- NPI
- 1104358233
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 480 Manor Plaza
Pacifica, CA 94044 - Phone
- (650) 355-8787
- Fax
- (650) 355-8780
- NPI assigned
- Mar 29, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
480 Manor Plaza
Pacifica, CA 94044
Mailing address
480 Manor Plaza
Pacifica, CA 94044
Phone (650) 355-8787
Other providers in Pacifica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2017. 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.