Stovall, Jerry
Stovall, Jerry is an sole proprietor health care provider with primary practice located at 2485 Old Eureka Way , Redding CA 96001-0336. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Stovall, Jerry can be contacted via phone (530) 242-8971.Contact Information
Primary practice address
2485 Old Eureka Way
Redding CA 96001-0336
Phone: (530) 242-8971
Fax: (530) 244-1546
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LCS16319 | California |
Profile Details
| NPI number | 1982730438 |
|---|---|
| LBN Legal business name | Stovall, Jerry |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 26th, 2007 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982730438 | NPPES |
| California | MEDICAID | CSW163190 |
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