Provider Demographics
NPI:1659496495
Name:PRESLEY, ANNETTE R (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:R
Last Name:PRESLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ANNETTE
Other - Middle Name:R
Other - Last Name:ORENDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 1288
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93639-1288
Mailing Address - Country:US
Mailing Address - Phone:559-673-3508
Mailing Address - Fax:559-661-2818
Practice Address - Street 1:209 E 7TH ST
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638-3780
Practice Address - Country:US
Practice Address - Phone:559-673-3508
Practice Address - Fax:559-661-2818
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 144691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ02760ZMedicare ID - Type UnspecifiedLICENSED CLINICAL SOCIAL