Provider Demographics
NPI:1568730166
Name:METCALF, MATTHEW ALLEN I (MSW)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:ALLEN
Last Name:METCALF
Suffix:I
Gender:M
Credentials:MSW
Other - Prefix:MR
Other - First Name:MATTHEW
Other - Middle Name:ALLEN
Other - Last Name:METCALF
Other - Suffix:I
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:600 HOSKING AVE
Mailing Address - Street 2:14C
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93307-5721
Mailing Address - Country:US
Mailing Address - Phone:661-859-9056
Mailing Address - Fax:
Practice Address - Street 1:600 HOSKING AVE
Practice Address - Street 2:14C
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307-5721
Practice Address - Country:US
Practice Address - Phone:661-859-9056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA297281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical