Healthcare Provider Details

I. General information

NPI: 1932592284
Provider Name (Legal Business Name): MARLENE L ABARCA ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2015
Last Update Date: 10/07/2020
Certification Date: 10/07/2020
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 TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number95604
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number95704
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: