Look up the most recent NPI and PECOS records

Audrey Mcdougal

Social Worker

Behavioral Health & Social Service Providers

400 Estudillo Ave Ste 100, San Leandro, CA 94577-4962

PECOS Enrollment

Based on the most recent information from CMS, provider Audrey Mcdougal does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1811236417
Provider Type
Individual
Full Name
Mcdougal, Audrey
Gender
Female

Sole Proprietor
No
Enumeration Date
2/4/2013
Last Updated
6/10/2024

Contact Information

Practice Location

400 Estudillo Ave Ste 100, San Leandro, CA 94577-4962

(510) 352-9200

Unlisted Fax

Mailing Location

400 Estudillo Ave Ste 100, San Leandro, CA 94577-4962

(510) 352-9200

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License LCSW106518 California
Code 101YM0800X	Description Counselor Behavioral Health & Social Service Providers	License ASW87597 California

Provider Identifiers

ID	Description	Issuer
ID 1300881	Description Medicaid	Issuer Unlisted Massachusetts

Audrey Mcdougal

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Galan-De Martinez, Lisa Carmel

Irvine, Paige

Cabrera Munoz, Diana Elizabeth

Fujii, Sarah

Jallad, Christina Marie

Sklar, Rebecca April

Stamnes, Catherine E

Yang, Yang A

Goitia, Denise

Sanftner, Serom