1952551434 NPI number — MS. MARGARET ELLEN RAINTREE L.C.S.W.

Table of content: MS. MARGARET ELLEN RAINTREE L.C.S.W. (NPI 1952551434)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952551434 NPI number — MS. MARGARET ELLEN RAINTREE L.C.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAINTREE
Provider First Name:
MARGARET
Provider Middle Name:
ELLEN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
L.C.S.W.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOMSY
Provider Other First Name:
MARGARET
Provider Other Middle Name:
RAINTREE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
L.C.S.W.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1952551434
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/21/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1335 MAIN ST STE 105
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT HELENA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94574-1940
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
707-494-1239
Provider Business Mailing Address Fax Number:
707-968-6125

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21152 CALISTOGA RE #203
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-494-1239
Provider Business Practice Location Address Fax Number:
707-968-6125
Provider Enumeration Date:
09/22/2008

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:  27018 , 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)

  • Identifier: GI130A . This is a "MEDICARE ID" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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