Healthcare Provider Details

I. General information

NPI: 1588676100
Provider Name (Legal Business Name): NORMA EDITH MACIAS MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2099 S STATE COLLEGE BLVD STE 250
ANAHEIM CA
92806-6134
US

IV. Provider business mailing address

1032C CABRILLO PARK DR APT A
SANTA ANA CA
92701-4438
US

V. Phone/Fax

Practice location:
  • Phone: 714-704-5900
  • Fax: 714-978-3419
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: