Moukdavanh Siackasorn
Moukdavanh Siackasorn is a Clinical Social Worker in Pittsburg, California. Licensed in California. Registered with an NPI since 2017.
- Licensed in
- CA
- In the registry since
- 2017
Practice location Address checks out
2311 Loveridge RdPittsburg, CA 94565-5117
Phone: (925) 431-2654
Fax: (925) 431-2644
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Specialties & licences
| Clinical Social Worker (primary) | Taxonomy 1041C0700X · Licence 94227 (CA) |
|---|
Record details
| NPI number | 1477098333 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | January 3, 2017 |
| Last updated in NPPES | March 3, 2020 |
| Certification date | March 3, 2020 |
| Mailing address | 2311 Loveridge Rd, Pittsburg, CA 94565-5117 |
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