Healthcare Provider Details

I. General information

NPI: 1235862541
Provider Name (Legal Business Name): CASSANDRA RAE OPRE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2022
Last Update Date: 07/05/2022
Certification Date: 07/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2130 E 4TH ST STE 200
SANTA ANA CA
92705-3818
US

IV. Provider business mailing address

2130 E 4TH ST STE 200
SANTA ANA CA
92705-3818
US

V. Phone/Fax

Practice location:
  • Phone: 714-543-5437
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW108106
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: