| Phyllis Farmer, | |
|
3645 Shadowbrook Dr, Stockton, CA 95219-1726 | |
| (209) 518-9789 | |
| Not Available |
| Full Name | Phyllis Farmer |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 3645 Shadowbrook Dr, Stockton, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639899818 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 79760 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | 20579 (Arizona) | Primary |
| Entity Name | Sud Specialty Group - Ca |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972138238 PECOS PAC ID: 9537534177 Enrollment ID: O20230412001370 |
| Mailing Address | Practice Location Address |
|---|---|
| Phyllis Farmer, 3645 Shadowbrook Dr, Stockton, CA 95219-1726 Ph: (209) 518-9789 | Phyllis Farmer, 3645 Shadowbrook Dr, Stockton, CA 95219-1726 Ph: (209) 518-9789 |
Mrs. Sue Ann Joy-smith, ASW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1201 N El Dorado St, Stockton, CA 95202 Phone: 209-468-3760 |
Donna L Bickham, ACSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1212 N California St, Stockton, CA 95202 Phone: 209-953-7313 Fax: 209-468-9633 |
Krystal Madeline Avila, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2495 W March Ln, Stockton, CA 95207 Phone: 209-465-1080 |
Shani Dharmasena, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1545 Saint Marks Plz, Stockton, CA 95207 Phone: 209-741-7888 |
Ms. Carol Jeanne Willmett, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1212 N California St, Stockton, CA 95202 Phone: 209-468-8296 Fax: 209-468-3516 |
Tiffany Dewitte, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1212 N California St, Stockton, CA 95202 Phone: 209-468-7462 |
Mrs. Torrie Alyn-hughes Piasecki, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 2105 W March Ln Ste 2, Stockton, CA 95207 Phone: 209-792-2759 |