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NPI Code Detail

MEDICARE: MS. ANYA ITHEL NEVAREZ LCSW

MEDICARE: MS. ANYA ITHEL NEVAREZ LCSW
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
11041C0700XClinical Social Worker78549CA

General Provider Information

NPI Number : 1629403803
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANYA ITHEL NEVAREZ LCSW
Provider Business Mailing Address
First Line : PO BOX 540
Second Line :
City : CHULA VISTA
State : CA
Zip : 91912-0540
Country : US
Telephone Number : 619-957-3753
Fax Number :
Provider Business Practice Location Address
First Line : 4930 NAPLES ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-3820
Country : US
Telephone Number : 619-276-1176
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2013
Last Update Date : 07/20/2022

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