MEDICARE: ASHLEIGH HIDALGO LCSW 129985

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	129985	CA

General Provider Information

NPI Number	:	1528539863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEIGH HIDALGO LCSW 129985

Provider Business Mailing Address
First Line	:	1695 MEDINAH RD
Second Line	:
City	:	SAN MARCOS
State	:	CA
Zip	:	92069-1177
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16516 BERNARDO CENTER DR STE 330
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-2552
Country	:	US
Telephone Number	:	858-333-6856
Fax Number	:

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

Provider Enumeration Date	:	12/16/2018
Last Update Date	:	11/05/2025

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