Provider Demographics
NPI:1609224278
Name:BUCON, ANNE KATHERINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:KATHERINE
Last Name:BUCON
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 1:3827 LOS SANTOS DR
Mailing Address - Street 2:
Mailing Address - City:CAMERON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:95682-8647
Mailing Address - Country:US
Mailing Address - Phone:530-677-0262
Mailing Address - Fax:530-672-0935
Practice Address - Street 1:3827 LOS SANTOS DR
Practice Address - Street 2:
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682-8647
Practice Address - Country:US
Practice Address - Phone:530-677-0262
Practice Address - Fax:530-672-0935
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 118411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical