Healthcare Provider Details

I. General information

NPI: 1093399420
Provider Name (Legal Business Name): DOROTHEA ELIZABETH WARE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2021
Last Update Date: 01/10/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

H200T SANTA MARGARITA RD BUILDING 2738T
CAMP PENDLETON CA
92057
US

IV. Provider business mailing address

H200T SANTA MARGARITA RD BUILDING 2738T
CAMP PENDLETON CA
92057
US

V. Phone/Fax

Practice location:
  • Phone: 760-725-0063
  • Fax:
Mailing address:
  • Phone: 760-725-0063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number20573
License Number StateOK

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: