Provider Demographics
NPI:1922542935
Name:FARMER, MEGAN KATHLEEN
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:KATHLEEN
Last Name:FARMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 GLENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-3463
Mailing Address - Country:US
Mailing Address - Phone:707-444-8293
Mailing Address - Fax:707-444-8298
Practice Address - Street 1:3300 GLENWOOD ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-3463
Practice Address - Country:US
Practice Address - Phone:707-444-8293
Practice Address - Fax:707-444-8298
Is Sole Proprietor?:No
Enumeration Date:2016-12-09
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator