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General NPI Number Information
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NPI Number | 1457144305
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Entity Type | Individual
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Provider Name | NICOLE DELONG ACSW
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Gender | Female
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Dates
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Enumeration Date | 05/23/2025
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 27225 CAMP PLENTY ROAD ST 7D
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City | SANTA CLARITA
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State | CA
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Zip | 91351
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Country | US
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Telephone | 661-347-0334
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Fax |
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Provider Business Mailing Address
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Address Line | 30402 MARSEILLE PL
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City | CASTAIC
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State | CA
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Zip | 91384-4773
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Country | US
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Telephone | 661-645-2518
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ASW128308
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License Number State | CA
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