MEDICARE: GALINA TROFIMOVNA STOROZHENKO LCSW, MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	121132	CA

General Provider Information

NPI Number	:	1518123215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GALINA TROFIMOVNA STOROZHENKO LCSW, MSW

Provider Business Mailing Address
First Line	:	330 MOSS ST
Second Line	:
City	:	CHULA VISTA
State	:	CA
Zip	:	91911-2005
Country	:	US
Telephone Number	:	619-585-4221
Fax Number	:

Provider Business Practice Location Address
First Line	:	11230 SORRENTO VALLEY RD STE 220
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-1300
Country	:	US
Telephone Number	:	858-648-5367
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2008
Last Update Date	:	09/11/2024

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