Clinton Taxdahl
Social Worker in Sacramento, CA. Individual provider (NPI-1).
NPI number1114200136
StatusActive
Last updated in NPPESSep 26, 2011
Details
- NPI
- 1114200136
- Entity type
- Individual (NPI-1)
- Name
- Mr. Clinton Taxdahl
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 26, 2011
- Last updated
- Sep 26, 2011
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 104100000X | Social Worker | – | – | Yes |
Practice location
719 J StSacramento, CA 95814-2501
Phone 916-444-3118
Mailing address
2277 Fair Oaks BlvdSte. 440
Sacramento, CA 95825-5533
Phone 916-441-0123
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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