Provider Demographics
NPI:1003958315
Name:SAWKA, BOBETTE RAE (LCSW)
Entity Type:Individual
Prefix:
First Name:BOBETTE
Middle Name:RAE
Last Name:SAWKA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BOBETTE
Other - Middle Name:RAE
Other - Last Name:GOETZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1411 PEREGRINE DR
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-7759
Mailing Address - Country:US
Mailing Address - Phone:913-523-4260
Mailing Address - Fax:
Practice Address - Street 1:1411 PEREGRINE DR
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-7759
Practice Address - Country:US
Practice Address - Phone:913-523-4260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20070030851041C0700X
KS6085104100000X
CA1211901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker