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NPI Code Detail

MEDICARE: ANNA LIZETTE PONCE ACSW

MEDICARE:   ANNA LIZETTE PONCE  ACSW
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 Worker119807CA

General Provider Information

NPI Number : 1700731031
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA LIZETTE PONCE ACSW
Provider Business Mailing Address
First Line : 200 MICHIGAN AVE
Second Line :
City : VISTA
State : CA
Zip : 92084-5424
Country : US
Telephone Number : 760-726-4900
Fax Number :
Provider Business Practice Location Address
First Line : 200 MICHIGAN AVE
Second Line :
City : VISTA
State : CA
Zip : 92084-5424
Country : US
Telephone Number : 760-726-4900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2026
Last Update Date : 03/02/2026

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Directions to “ ANNA LIZETTE PONCE ACSW” Practice Location

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