| Doctor Name: | MS. COLEEN TRAVERS |
| NPI Number: | 1013995968 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW, ACSW |
| License Number: | 26068 |
| Business Practice Address: | 1101 Welch Rd Suite A-1, Mc 5776 Palo Alto, CA - 943041904 |
| Business Phone Number: | 6507362613 |
| Business Fax Number: | 6507242550 |
| Mailing Address: | 1101 Welch Rd, Suite A-1, Mc 5776, Stanford Coordinated Care STANFORD |
| State: | CA |
| Postal Code: | 94304 |
| Phone Number: | 6507362613 |
| Fax Number: | 6507242550 |
| NPI Enumeration Date: | 01/01/2006 |
| NPI Last Update Date: | 07/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 26068 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |