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General NPI Number Information
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NPI Number | 1497004097
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Entity Type | Individual
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Provider Name | VONDA ANN SIGSTAD LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/29/2012
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Last Update Date | 09/11/2012
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Provider Practice Location Address
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Address Line | 27851 BRADLEY RD STE 101
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City | MENIFEE
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State | CA
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Zip | 92586-2286
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Country | US
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Telephone | 951-473-0307
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 1219
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City | MURREITA
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State | CA
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Zip | 92564
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Country | US
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Telephone | 951-834-4204
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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 | LCS 25224
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License Number State | CA
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