Basic Information
| Provider Information | |||||||||
| NPI: | 1477695062 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | METCALF | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | R. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1460 CRESCENT CT | ||||||||
| Address2: | |||||||||
| City: | YUBA CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959916713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308229820 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1965 LIVE OAK BLVD | ||||||||
| Address2: | |||||||||
| City: | YUBA CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959918828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308227200 | ||||||||
| FaxNumber: | 5308223296 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | RA834300 | CA | X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 1041C0700X | 20192 | CA | X | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.