Provider Demographics
NPI:1649478736
Name:MEYER, JAMES H (LCSW)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:MEYER
Suffix:
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 1:25 CADILLAC DR
Mailing Address - Street 2:STE #132
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-8349
Mailing Address - Country:US
Mailing Address - Phone:916-494-9218
Mailing Address - Fax:916-282-1698
Practice Address - Street 1:25 CADILLAC DR
Practice Address - Street 2:STE #132
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-8349
Practice Address - Country:US
Practice Address - Phone:916-494-9218
Practice Address - Fax:916-282-1698
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW62672104100000X
CALCSW 626721041C0700X
CA626721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical