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NPI Code Detail

MEDICARE: MS. ASHLEY ERIN KOKJOHN MSW

MEDICARE: MS. ASHLEY ERIN KOKJOHN 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
1104100000XSocial Worker

General Provider Information

NPI Number : 1780782821
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ASHLEY ERIN KOKJOHN MSW
Provider Business Mailing Address
First Line : 3020 CHILDRENS WAY # 5018
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-4223
Country : US
Telephone Number : 858-716-9433
Fax Number :
Provider Business Practice Location Address
First Line : 5650 MOUNT ACKERLY DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-4016
Country : US
Telephone Number : 858-569-6271
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 07/08/2007

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