Emma Black
Individual provider Active NPI Clinical Social Worker · Beale Afb, CA
NPI 1306574983 · NPPES record last updated Aug 21, 2023
Key facts
- NPI
- 1306574983
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 8585628-3501 (UT)
- Practice address
- 15301 Warren Shingle Rd
Beale Afb, CA 95903-1905 - Phone
- (530) 634-3420
- NPI assigned
- Aug 11, 2022
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8585628-3501 | UT | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 8585628-3501 | UT | Yes |
Addresses
Primary practice location
15301 Warren Shingle Rd
Beale Afb, CA 95903-1905
Mailing address
15301 Warren Shingle Rd
Beale Afb, CA 95903-1905
Phone (530) 634-3420
Other providers in Beale Afb, CA
- Sumit Bagga
- Susan Berganio
- Timber Ann Best
- Evan Wesley Birchard
- Eileen Bird
- Angelo J. Boss
- John Patrick Bossalini
- Joel Edward Brady
- Sadina Lynn Brecheisen-Beach
- Joshua Thomas Breding
All providers in Beale Afb, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2023. 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.