Provider Demographics
NPI:1952608432
Name:GATES, JANET LIA (LCSW)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:LIA
Last Name:GATES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11230 GOLD EXPRESS DR STE 310-154
Mailing Address - Street 2:
Mailing Address - City:GOLD RIVER
Mailing Address - State:CA
Mailing Address - Zip Code:95670-4484
Mailing Address - Country:US
Mailing Address - Phone:510-685-8903
Mailing Address - Fax:888-796-2876
Practice Address - Street 1:2377 GOLD MEADOW WAY STE 100
Practice Address - Street 2:
Practice Address - City:GOLD RIVER
Practice Address - State:CA
Practice Address - Zip Code:95670-4444
Practice Address - Country:US
Practice Address - Phone:916-370-6179
Practice Address - Fax:888-796-2876
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-18
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA254791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical