Jamie Costello Kenwood LCSW

NPI 1316113525 - Social Worker - 1041C0700X

NPI Details
NPI 1316113525
Gender Female
Enumeration Date 05/07/2008
Last Updated 05/07/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
PRISON RD
CALIFORNIA STATE PRISON SACRAMENTO
REPRESA CA, 95670, US
Phone (916) 324-6317
Fax (916) 294-3195
Business Location
PO BOX 290010
REPRESA CA, 95671-0010, US
Phone (916) 324-6317
Fax (916) 294-3195
Toxanomy
Taxonomy Code 1041C0700X
License State California
License Number 23573
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According to our database, Ms. Jamie Costello Kenwood LCSW NPI is 1316113525, taxonomy code is 1041C0700X and license number is 23573, license state is located at California. Jamie Costello Kenwood LCSW physically located at Prison Rd, Represa CA, 95670. NPI Number Jamie Costello Kenwood LCSW has the Individual type.

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1316113525 NPI number is provided on an as is basis without warranty of any kind. 1316113525 is maintained by the National Plan & Provider Enumeration System. The contents of Jamie Costello Kenwood LCSW are for informational purposes only.