Brenda Church, LCSW

Individual provider Active NPI Clinical Social Worker · Selma, CA

NPI 1477858629 · NPPES record last updated Jan 20, 2011

Key facts

NPI
1477858629
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
LCS23267 (CA)
Practice address
2711 Cinema Way Ste 111
Selma, CA 93662-2677
Phone
(559) 891-2750
NPI assigned
Jan 20, 2011
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

LicenseStateTypeSpecialty
LCS23267CAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS23267 CA Yes

Addresses

Primary practice location

2711 Cinema Way Ste 111
Selma, CA 93662-2677

Mailing address

8600 Kansas Ave
Hanford, CA 93230-9565
Phone (559) 582-1612

Other providers in Selma, CA

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

Sources for this page

Verify at the official NPI Registry.