Healthcare Provider Details

I. General information

NPI: 1851914840
Provider Name (Legal Business Name): CILLA ZIEMLANSKI MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2020
Last Update Date: 05/25/2020
Certification Date: 05/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S MANCHESTER AVE STE 740
ORANGE CA
92868-3217
US

IV. Provider business mailing address

200 S MANCHESTER AVE STE 740
ORANGE CA
92868-3217
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-5798
  • Fax:
Mailing address:
  • Phone: 714-456-5798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number18490
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number18490CA
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: