Patricia Alexandra Green, LCSW
Individual provider Active NPI Clinical Social Worker · Loomis, CA
NPI 1679639215 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1679639215
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LCS16020 (CA)
- Practice address
- 3805 Taylor Rd
Suite 1
Loomis, CA 95650-9271 - Phone
- (916) 652-7470
- Fax
- (916) 652-7065
- NPI assigned
- Dec 28, 2006
- 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)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS16020 | CA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS16020 | CA | Yes |
Addresses
Primary practice location
3805 Taylor Rd
Suite 1
Loomis, CA 95650-9271
Mailing address
3805 Taylor Rd
Suite 1
Loomis, CA 95650-9271
Phone (916) 652-7470
Other providers in Loomis, CA
- Donna Gilreath
- Leslie Ann Giovannoni
- Merle Franklin Godfrey III
- Gold Mountain Transport LLC
- Gary Alan Gramm
- Erica Gugielmi
- Annette Gustafsson
- Haley Jane Hansen
- Heidi Mary Harvey
- Heartstrings Counseling, Inc
All providers in Loomis, 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 Jul 8, 2007. 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.