Provider Demographics
NPI:1811416829
Name:PICKERING, ELIZABETH FE (LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:FE
Last Name:PICKERING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:FE
Other - Last Name:PICKERING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3400 MONTGOMERY DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-5142
Mailing Address - Country:US
Mailing Address - Phone:707-526-6902
Mailing Address - Fax:707-526-6972
Practice Address - Street 1:3400 MONTGOMERY DR
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-5142
Practice Address - Country:US
Practice Address - Phone:707-526-6902
Practice Address - Fax:707-526-6972
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1089961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical