Healthcare Provider Details

I. General information

NPI: 1043765688
Provider Name (Legal Business Name): BERNICE TABIL-GALAPON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BERNICE TABIL

II. Dates (important events)

Enumeration Date: 08/24/2016
Last Update Date: 08/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 N DATE ST
ESCONDIDO CA
92025-3413
US

IV. Provider business mailing address

30788 LORING PARK CIR
MENIFEE CA
92584-7020
US

V. Phone/Fax

Practice location:
  • Phone: 760-737-6935
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW27824
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: