Provider Demographics
NPI:1174012983
Name:FOSTER, PAMELLA JO (LCSW)
Entity Type:Individual
Prefix:
First Name:PAMELLA
Middle Name:JO
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16275 MONTEREY RD STE C
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-5466
Mailing Address - Country:US
Mailing Address - Phone:408-778-5120
Mailing Address - Fax:
Practice Address - Street 1:16275 MONTEREY RD STE C
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-5466
Practice Address - Country:US
Practice Address - Phone:408-778-5120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18252104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker