Provider Demographics
NPI:1790739803
Name:BUFFINGTON, JAMES ANDREW JR (LCSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ANDREW
Last Name:BUFFINGTON
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2036 NEVADA CITY HWY # 237
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-7700
Mailing Address - Country:US
Mailing Address - Phone:530-477-7016
Mailing Address - Fax:
Practice Address - Street 1:2036 NEVADA CITY HWY # 237
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-7700
Practice Address - Country:US
Practice Address - Phone:530-477-7016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 294001041C0700X
PACW008896L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA058758J25Medicare PIN