Timothy Paul Suderman in Elk Grove - Clinical
Timothy Paul Suderman - NPI 1376766188
Timothy Paul Suderman is a Clinical in Elk Grove, California. Timothy Paul Suderman practices all healthcare services and medical treatments related to Clinical. The NPI Number for Timothy Paul Suderman is 1376766188. The last update date is 2007-07-08.
Timothy Paul Suderman's current location address is 3412 Grimshaw Way, Elk Grove, California. You can contact this provider via phone number 9166839826. The mailing address for Timothy Paul Suderman is 3412 Grimshaw Way, Elk Grove, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Timothy Paul Suderman |
|---|---|
| Address | 3412 Grimshaw Way, Elk Grove, California |
| Phone Number | 9166839826 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1376766188 |
|---|---|
| Provider Enumeration Date | 2007-04-10 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 3412 Grimshaw Way |
|---|---|
| City | Elk Grove |
| State | California (CA) |
| Post Code | 957584594 |
| Phone Number | 9166839826 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | LCS21102 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique 10-digit identification code issued to Timothy Paul Suderman by the Centers for Medicare & Medicaid Services?
The Timothy Paul Suderman has been assigned the NPI (National Provider Identifier) 1376766188 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you kindly provide the complete physical address where Timothy Paul Suderman's facilities are geographically located?
The facilities of Timothy Paul Suderman are physically situated at the following location: 3412 Grimshaw Way, Elk Grove, CA, 957584594.
What is Timothy Paul Suderman's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Timothy Paul Suderman is Clinical, and the corresponding taxonomy classification code for this specialized field is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1376766188 to Timothy Paul Suderman?
The Centers for Medicare & Medicaid Services originally issued the 1376766188 to Timothy Paul Suderman on 2007-04-10.
As of what date were the details pertaining to Timothy Paul Suderman last refreshed?
The information related to the Timothy Paul Suderman, including its address, specialty, and other relevant details, was last updated on 2007-07-08.