Healthcare Provider Details

I. General information

NPI: 1801045349
Provider Name (Legal Business Name): CHARITY ANN LAZZARI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2008
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3220 33RD ST
SAN DIEGO CA
92104-4726
US

IV. Provider business mailing address

2801 B ST # 2031
SAN DIEGO CA
92102-2208
US

V. Phone/Fax

Practice location:
  • Phone: 619-339-5006
  • Fax:
Mailing address:
  • Phone: 619-339-5006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number74490
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: