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General NPI Number Information
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NPI Number | 1518368331
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Entity Type | Individual
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Provider Name | ANDREW MARCUS DELGADO LCSW
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Gender | Male
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Dates
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Enumeration Date | 09/11/2014
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Last Update Date | 01/22/2020
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Provider Practice Location Address
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Address Line | 3750 ROHNERVILLE ROAD
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City | FORTUNA
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State | CA
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Zip | 95540
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Country | US
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Telephone | 707-725-6101
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Fax | 707-725-2978
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Provider Business Mailing Address
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Address Line | PO BOX 1045
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City | ARCATA
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State | CA
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Zip | 95518-1045
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Country | US
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Telephone | 707-572-9440
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | L6320
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License Number State | OR
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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 | LCSW87293
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | L6320
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License Number State | OR
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