Healthcare Provider Details

I. General information

NPI: 1396736195
Provider Name (Legal Business Name): PATRICIA WOJDOWSKI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: CHERRY PATRICIA WOJDOWSKI LCSW

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4926 LA CUENTA DR SUITE 200
SAN DIEGO CA
92124-2609
US

IV. Provider business mailing address

4926 LA CUENTA DR SUITE 200
SAN DIEGO CA
92124-2609
US

V. Phone/Fax

Practice location:
  • Phone: 858-292-0492
  • Fax: 619-296-2130
Mailing address:
  • Phone: 858-292-0492
  • Fax: 619-296-2130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW 8537
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: