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General NPI Number Information
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NPI Number | 1386893857
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Entity Type | Individual
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Provider Name | SHIRLEY MATIAS ROMULO LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/09/2008
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Last Update Date | 08/23/2020
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Provider Practice Location Address
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Address Line | 1900 E LA PALMA AVE STE 101
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City | ANAHEIM
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State | CA
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Zip | 92805-1636
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Country | US
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Telephone | 714-399-3480
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Fax |
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Provider Business Mailing Address
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Address Line | 2110 ALMERIA ST UNIT 104
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City | CORONA
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State | CA
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Zip | 92879-7937
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Country | US
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Telephone | 951-818-1368
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 |
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License Number State | CA
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