Organization
VA HEALTH CARE SYSTEM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DORETHA JEAN MYERS P-LCSW (CLINICAL SOCIAL WORKER)
(650) 493-5000
Entity
Organization
Contact information
Practice address
3801 MIRANDA AVE, PALO ALTO, CA 94304-1207
(650) 493-5000
(650) 617-2614
Mailing address
795 WILLOW ROAD, MENLO PARK, CA 94025
(650) 493-5000
(650) 617-2614
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
P003597
NC
Other
Enumeration date
06/25/2009
Last updated
06/25/2009
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