Mark Richard Odom is a Clinical in Santa Ana, California. Mark Richard Odom practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mark Richard Odom is 1881780542. The last update date is 2007-07-08.
Mark Richard Odom's current location address is 1540 E 1st St, Santa Ana, California. You can contact this provider via phone number 7149723700. The mailing address for Mark Richard Odom is 1540 E 1st St, Santa Ana, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark Richard Odom |
|---|---|
| Address | 1540 E 1st St, Santa Ana, California |
| Phone Number | 7149723700 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1881780542 |
|---|---|
| Provider Enumeration Date | 2006-10-04 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1540 E 1st St |
|---|---|
| City | Santa Ana |
| State | California (CA) |
| Post Code | 927016341 |
| Phone Number | 7149723700 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | LCS 18745 |
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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 identifier code assigned to Mark Richard Odom by the Centers for Medicare & Medicaid Services?
The Mark Richard Odom has been issued the NPI (National Provider Identifier) 1881780542 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you share the physical location details of Mark Richard Odom?
The Mark Richard Odom is situated at 1540 E 1St St, in the city of Santa Ana, state of CA, with the zip code 927016341.
What is the Mark Richard Odom's area of specialization and corresponding taxonomy classification?
The Mark Richard Odom's specialty field is Clinical, and it falls under the taxonomy code 1041C0700X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services issue the 1881780542 to Mark Richard Odom?
The Mark Richard Odom received its 1881780542 assignment from the Centers for Medicare & Medicaid Services on 2006-10-04.
When was the information pertaining to Mark Richard Odom most recently updated or revised?
The details related to Mark Richard Odom, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-08.