Healthcare Provider Details

I. General information

NPI: 1699333641
Provider Name (Legal Business Name): ALEJANDRO DEL CID ACSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2019
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date: 09/03/2025
Reactivation Date: 09/19/2025

III. Provider practice location address

5000 BIRCH ST STE 3000
NEWPORT BEACH CA
92660-2140
US

IV. Provider business mailing address

12021 WILMINGTON AVE
LOS ANGELES CA
90059-3019
US

V. Phone/Fax

Practice location:
  • Phone: 714-455-9705
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW140658
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: