Healthcare Provider Details

I. General information

NPI: 1134855018
Provider Name (Legal Business Name): ARCELITO AGGABAO GLORIOSO LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2022
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15611 POMERADO RD STE 535
POWAY CA
92064-2413
US

IV. Provider business mailing address

15611 POMERADO RD STE 535
POWAY CA
92064-2413
US

V. Phone/Fax

Practice location:
  • Phone: 858-279-1223
  • Fax:
Mailing address:
  • Phone: 858-279-1223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number136851
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: