Healthcare Provider Details

I. General information

NPI: 1184725665
Provider Name (Legal Business Name): JOSEPHINE AYE ROEMHILD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOSEPHINE AYE MSW

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 11/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 PARK COURT PL BLDG H
SANTA ANA CA
92701-5028
US

IV. Provider business mailing address

1801 PARK COURT PL BLDG H
SANTA ANA CA
92701-5028
US

V. Phone/Fax

Practice location:
  • Phone: 714-957-1004
  • Fax:
Mailing address:
  • Phone: 714-957-1004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number27844
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: