1811018849 NPI number — MS. VIRGINIA ANNE HASSRICK LCSW

Table of content: MS. VIRGINIA ANNE HASSRICK LCSW (NPI 1811018849)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811018849 NPI number — MS. VIRGINIA ANNE HASSRICK LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HASSRICK
Provider First Name:
VIRGINIA
Provider Middle Name:
ANNE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HASSRICK
Provider Other First Name:
GINNI
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1811018849
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
517 THIRD ST
Provider Second Line Business Mailing Address:
STE 35
Provider Business Mailing Address City Name:
EUREKA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
707-444-8797
Provider Business Mailing Address Fax Number:
707-444-8797

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
517 THIRD ST
Provider Second Line Business Practice Location Address:
STE 35
Provider Business Practice Location Address City Name:
EUREKA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-444-8797
Provider Business Practice Location Address Fax Number:
707-444-8797
Provider Enumeration Date:
04/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  CAL LCS16693 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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