Individual
MR. ANTHONY MEDARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3880 S BASCOM AVE, SUITE 212, SAN JOSE, CA 95124-2674
(408) 377-7099
(408) 377-7833
Mailing address
3880 S BASCOM AVE, SUITE 212, SAN JOSE, CA 95124-2674
(408) 377-7099
(408) 377-7833
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS11369
CA
Other
Enumeration date
02/21/2007
Last updated
07/08/2007
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