Provider Demographics
NPI:1700761327
Name:LANDSITTEL-KIRIN, ADRIENNE (MSW, ASW)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:LANDSITTEL-KIRIN
Suffix:
Gender:F
Credentials:MSW, ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-0366
Mailing Address - Country:US
Mailing Address - Phone:916-276-5778
Mailing Address - Fax:
Practice Address - Street 1:4212 MISSOURI FLAT RD
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-6269
Practice Address - Country:US
Practice Address - Phone:530-621-7700
Practice Address - Fax:530-621-7713
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW1329501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical