Healthcare Provider Details

I. General information

NPI: 1326674565
Provider Name (Legal Business Name): AARON BRIAN SKOBEL LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2020
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 CAMINO DEL RIO S STE 315
SAN DIEGO CA
92108-3784
US

IV. Provider business mailing address

5333 BALTIMORE DR APT 106
LA MESA CA
91942-2097
US

V. Phone/Fax

Practice location:
  • Phone: 619-500-2312
  • Fax:
Mailing address:
  • Phone: 619-500-2312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number80984
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number80984
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number121128
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: