Victoria Georgia Landes, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS18104 Issued in CA

Practice address

175 Concourse Blvd
Santa Rosa, CA 95403-8217

Phone

(707) 284-9200

Fax

(707) 284-9254

NPI assigned

Sep 18, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190073600000",
    "number": "1932395563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 ALBATROSS DR",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949451506",
            "telephone_number": "415-717-7737",
            "fax_number": "415-898-9614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 CONCOURSE BLVD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954038217",
            "telephone_number": "707-284-9200",
            "fax_number": "707-284-9254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDES",
        "first_name": "VICTORIA",
        "middle_name": "GEORGIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2007-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS18104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maya Mitchell Land, MD
• Alfredo Landa Soto
• Trevor Landas, MD
• Renee Lande
• Julie K Landecker, DPT
• Robert Landman, MD
• Benjamin Mark Landucci
• Erin Lane
• Genavive Lane
• David Lang

• Clinical Social Worker in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.