Healthcare Provider Details

I. General information

NPI: 1811762941
Provider Name (Legal Business Name): MICHAEL ANNORENO LICENSED CLINICAL SOCIAL WORKER APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2023
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44709 DATE AVE
LANCASTER CA
93534-3101
US

IV. Provider business mailing address

44709 DATE AVE
LANCASTER CA
93534-3101
US

V. Phone/Fax

Practice location:
  • Phone: 661-441-6568
  • Fax:
Mailing address:
  • Phone: 661-441-6568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: MICHAEL ANNORENO
Title or Position: THERAPIST
Credential:
Phone: 661-441-6568