Healthcare Provider Details

I. General information

NPI: 1386636819
Provider Name (Legal Business Name): STEVEN WAYNE CAPPIELLO MSW, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL, CAMP PENDLETON SANTA MARGARITA ROAD BLDG H100 CODE CS-PA
CAMP PENDLETON CA
92055
US

IV. Provider business mailing address

32116 CAMINO NUNEZ
TEMECULA CA
92592-6357
US

V. Phone/Fax

Practice location:
  • Phone: 760-725-1318
  • Fax:
Mailing address:
  • Phone: 951-699-2053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC11523
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: