Provider Demographics
NPI:1144755620
Name:MATSUMOTO, ANN MCQUESTON
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MCQUESTON
Last Name:MATSUMOTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:ELIZABETH
Other - Last Name:MCQUESTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:4066 CASTLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518-1826
Mailing Address - Country:US
Mailing Address - Phone:410-627-8128
Mailing Address - Fax:
Practice Address - Street 1:4066 CASTLEWOOD CT
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-1826
Practice Address - Country:US
Practice Address - Phone:410-627-8128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-21
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA755801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical