Healthcare Provider Details

I. General information

NPI: 1154404689
Provider Name (Legal Business Name): VIVIANA AIDA SCHILPP LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 E CHAPMAN AVE
ORANGE CA
92866-1620
US

IV. Provider business mailing address

707 E CHAPMAN AVE
ORANGE CA
92866-1620
US

V. Phone/Fax

Practice location:
  • Phone: 714-528-3292
  • Fax: 714-771-2693
Mailing address:
  • Phone: 714-528-3292
  • Fax: 714-771-2693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number20836
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: