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NPI 1689216616 · live from the CMS NPI Registry

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Social Worker, Clinical in Volcano, HI. National Provider Identifier 1689216616, active.

NPI record

NPI1689216616 Type 2 · organization
StatusActive
Primary specialtySocial Worker, Clinical 1041C0700X
Practice location11-3784 2nd St, Volcano, HI 96785
Practice phone210-527-8755
Mailing address2186 Jackson Keller Rd, Pmb 3081, San Antonio, TX 78213
EnumeratedOctober 10, 2019
Last updatedJuly 6, 2023
Authorized officialJesse Cardin, Founder/Owner/Manager/Provider

Taxonomies and licenses

TaxonomyCodeLicense
Social Worker, Clinical primary1041C0700X—

Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.