| Mr Mario Walther Victor, MSW | |
|
39650 Liberty St, Fremont, CA 94538-2223 | |
| (510) 498-2890 | |
| Not Available |
| Full Name | Mr Mario Walther Victor |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 39650 Liberty St, Fremont, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093853103 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 20292 (California) | Primary |
| Entity Name | Sutter Bay Medical Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013950807 PECOS PAC ID: 4284538778 Enrollment ID: O20031125000909 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Mario Walther Victor, MSW 325 Distel Cir, Los Altos, CA 94022-1408 Ph: (510) 498-2890 | Mr Mario Walther Victor, MSW 39650 Liberty St, Fremont, CA 94538-2223 Ph: (510) 498-2890 |
Tina Howerton, ASW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3607 Main St Ste A, Fremont, CA 94538 Phone: 510-270-1200 Fax: 510-249-9623 | |
Leilei Yuan, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 39111 Paseo Padre Pkwy Ste 203e, Fremont, CA 94538 Phone: 443-831-4321 | |
Clarissa Chanelle Cannon, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1860 Mowry Ave Ste 400, Fremont, CA 94538 Phone: 510-770-8040 | |
Miss Lauren Ashlei Pina, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 39119 Liberty Street, Building B Room 118 Fre-122-sw, Fremont, CA 94538 Phone: 510-791-4000 | |
Silvia Gomez, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 39420 Liberty St Ste 265, Fremont, CA 94538 Phone: 617-993-6130 | |
Mariam Kiara Lowe, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 39155 Liberty St Ste A110, Fremont, CA 94538 Phone: 510-574-2000 | |
Viju Veliyath Thomas, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 39155 Liberty St, Suite G710, Fremont, CA 94538 Phone: 510-795-2434 |