Basic Information
| Provider Information | |||||||||
| NPI: | 1245717404 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARTWRIGHT | ||||||||
| FirstName: | GENOVEVA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | ASW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 215 W BEAMER ST | ||||||||
| Address2: | |||||||||
| City: | WOODLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956952510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5304052815 | ||||||||
| FaxNumber: | 5302045255 | ||||||||
| Practice Location | |||||||||
| Address1: | 215 W BEAMER ST | ||||||||
| Address2: | |||||||||
| City: | WOODLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956952510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5304052815 | ||||||||
| FaxNumber: | 5302045255 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2018 | ||||||||
| LastUpdateDate: | 07/20/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 82794 | CA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.