Ratana Tak, L.C.S.W.
Individual provider Active NPI Clinical Social Worker · Avenal, CA
NPI 1922440643 · NPPES record last updated Jul 23, 2013
Key facts
- NPI
- 1922440643
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LCS 27679 (CA)
- Practice address
- 1 Kings Way
Avenal, CA 93204-9708 - Phone
- (559) 386-0587
- NPI assigned
- Jul 23, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| LCS 27679 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corrections and Rehabilitation-Headquarters | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS 27679 | CA | Yes |
Addresses
Primary practice location
1 Kings Way
Avenal, CA 93204-9708
Mailing address
1 Kings Way
Avenal, CA 93204-9708
Phone (559) 386-0587
Other providers in Avenal, CA
- Jeffer Y Sabino
- Mark Masami Sakai
- Lisa Marie Slosarik
- Tyler Jensen Smith
- Camille Ross Summons
- Christal L Torres
- Dao Bic Tran
- Bao Vinh Trinh
- Kenneth Tsutsui
- Yesenia Valle
All providers in Avenal, 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 23, 2013. 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.