Healthcare Provider Details

I. General information

NPI: 1073709267
Provider Name (Legal Business Name): JOHN WILLIAM ADSIT LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 09/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 THE CITY DR S
ORANGE CA
92868-3201
US

IV. Provider business mailing address

PO BOX 54739
LOS ANGELES CA
90054-0739
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-5902
  • Fax: 714-456-5112
Mailing address:
  • Phone: 949-824-1283
  • Fax: 949-824-9891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS10029
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: