Healthcare Provider Details

I. General information

NPI: 1053611418
Provider Name (Legal Business Name): BARBARA WOHLANDER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2010
Last Update Date: 11/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4147 ADAMS AVE
SAN DIEGO CA
92116-2509
US

IV. Provider business mailing address

9525 VERVAIN ST
SAN DIEGO CA
92129-3523
US

V. Phone/Fax

Practice location:
  • Phone: 619-851-3290
  • Fax: 858-484-3290
Mailing address:
  • Phone: 858-484-6998
  • Fax: 858-484-3290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS7732
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: