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General NPI Number Information
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NPI Number | 1184057655
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Entity Type | Individual
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Provider Name | CLAUDIA F JESUS DE SEPE LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/19/2013
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 3611 S. HARBOR BLVD. SUITE 100
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City | SANTA ANA
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State | CA
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Zip | 92704
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Country | US
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Telephone | 909-251-9352
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1612
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City | FONTANA
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State | CA
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Zip | 92334-1612
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 104504
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License Number State | CA
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