Provider Demographics
NPI:1700274438
Name:GROPP, JUDITH (LCSW)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:
Last Name:GROPP
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 1:24121 MILK RANCH RD
Mailing Address - Street 2:NONE
Mailing Address - City:COLFAX
Mailing Address - State:CA
Mailing Address - Zip Code:95713-9545
Mailing Address - Country:US
Mailing Address - Phone:530-305-4663
Mailing Address - Fax:
Practice Address - Street 1:24121 MILK RANCH RD
Practice Address - Street 2:NONE
Practice Address - City:COLFAX
Practice Address - State:CA
Practice Address - Zip Code:95713-9545
Practice Address - Country:US
Practice Address - Phone:530-305-4663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA268191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical