| Krystal D Fortner, LCSW | |
|
214 Bayside Ct, Richmond, CA 94804-7461 | |
| (415) 845-8416 | |
| Not Available |
| Full Name | Krystal D Fortner |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 214 Bayside Ct, Richmond, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588990378 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCS 26019 (California) | Primary |
| Entity Name | Grow Healthcare Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154994846 PECOS PAC ID: 1850774746 Enrollment ID: O20220809004080 |
| Mailing Address | Practice Location Address |
|---|---|
| Krystal D Fortner, LCSW 214 Bayside Ct, Richmond, CA 94804-7461 Ph: (415) 845-8416 | Krystal D Fortner, LCSW 214 Bayside Ct, Richmond, CA 94804-7461 Ph: (415) 845-8416 |
Phoebe Watts, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 575 Berk Ave Apt 2, Richmond, CA 94804 Phone: 510-395-1035 | |
Ms. Susan Miriam Seglin, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 901 Nevin Ave, Richmond, CA 94801 Phone: 510-307-1612 Fax: 510-307-1615 | |
Margaret Mullen, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 901 Nevin Ave, Richmond, CA 94801 Phone: 510-307-1771 Fax: 510-307-1615 | |
Ms. Diana Baires, ASW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 205 39th St, Richmond, CA 94805 Phone: 510-412-5930 | |
Ms. Cynthia Bloomfield, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4175 Lakeside Dr, 150, Richmond, CA 94806 Phone: 510-520-8179 | |
Michael David Lim, L.C.S.W. Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 901 Nevin Ave, Richmond, CA 94801 Phone: 510-307-1650 Fax: 510-307-1615 | |
Ms. Diana Suzanne Smith, L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4101 Macdonald Ave, Richmond, CA 94805 Phone: 510-412-9200 |