| Nancy Mardis, LCSW | |
|
12755 N Highway 88, Lodi, CA 95240-9323 | |
| (209) 340-7900 | |
| Not Available |
| Full Name | Nancy Mardis |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 12755 N Highway 88, Lodi, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124138425 | NPI | - | NPPES |
| 2376 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW 18663 (California) | Primary |
| Entity Name | Permanente Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
| Mailing Address | Practice Location Address |
|---|---|
| Nancy Mardis, LCSW Po Box 330, Victor, CA 95253-0330 Ph: (209) 340-7900 | Nancy Mardis, LCSW 12755 N Highway 88, Lodi, CA 95240-9323 Ph: (209) 340-7900 |
Frances A Engel, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2000 W Ketteman Ln, Ste #103, Lodi, CA 95242 Phone: 209-339-3802 Fax: 209-759-9387 | |
Leslie Kayla Corrales-solorio, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 312 N School St, Lodi, CA 95240 Phone: 209-582-5233 | |
Jacqueline Cantellano, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: Po Box 251, Lodi, CA 95241 Phone: 209-922-1053 | |
Rebecca Anjanette Frame, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 421 N School St, Lodi, CA 95240 Phone: 209-747-4831 | |
Enedelia Lopez, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 13451 N Extension Rd, Lodi, CA 95242 Phone: 209-953-8301 | |
Diana Holt, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 315 Pine St, Lodi, CA 95240 Phone: 209-366-2273 Fax: 209-366-2976 |