Organization
C.I.P.G.A.-LICENSED CLINICAL SOCIAL WORKER INC. PROF. CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA BEAN-JENSEN LCSW (CEO/SECRETARY)
(707) 567-1189
Entity
Organization
Contact information
Practice address
419 ELIZABETH ST STE 1, VACAVILLE, CA 95688-4602
(707) 567-1189
Mailing address
419 ELIZABETH ST STE 1, VACAVILLE, CA 95688-4602
(707) 567-1189
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LCS21093
CA
Other
Enumeration date
03/25/2008
Last updated
09/23/2010
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