Healthcare Provider Details

I. General information

NPI: 1790981140
Provider Name (Legal Business Name): PATRICIA JOANNE FIAMENGO LCSW, M-RAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5083 SLEEPING INDIAN RD
FALLBROOK CA
92028-8516
US

IV. Provider business mailing address

5083 SLEEPING INDIAN RD
FALLBROOK CA
92028-8516
US

V. Phone/Fax

Practice location:
  • Phone: 760-420-1683
  • Fax: 866-511-7554
Mailing address:
  • Phone: 760-420-1683
  • Fax: 866-511-7554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number99291
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: