Provider Demographics
NPI:1811018849
Name:HASSRICK, VIRGINIA ANNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:ANNE
Last Name:HASSRICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:GINNI
Other - Middle Name:
Other - Last Name:HASSRICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:517 THIRD ST
Mailing Address - Street 2:STE 35
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501
Mailing Address - Country:US
Mailing Address - Phone:707-444-8797
Mailing Address - Fax:707-444-8797
Practice Address - Street 1:517 THIRD ST
Practice Address - Street 2:STE 35
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501
Practice Address - Country:US
Practice Address - Phone:707-444-8797
Practice Address - Fax:707-444-8797
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACAL LCS166931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ15428ZMedicare ID - Type Unspecified