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NPI Code Detail

MEDICARE: MEGAN HARRIS

MEDICARE: MEGAN HARRIS
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 Worker104691CA

General Provider Information

NPI Number : 1750743126
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN HARRIS
Provider Business Mailing Address
First Line : 73 N 2ND AVE
Second Line :
City : CHULA VISTA
State : CA
Zip : 91910-1124
Country : US
Telephone Number : 619-426-3595
Fax Number :
Provider Business Practice Location Address
First Line : 1127 S 38TH ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92113-3210
Country : US
Telephone Number : 619-262-4002
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2016
Last Update Date : 10/13/2021

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