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General NPI Number Information
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NPI Number | 1780020685
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Entity Type | Individual
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Provider Name | DEMETRIO NAVA ACSW
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Gender | Male
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Dates
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Enumeration Date | 05/17/2013
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Last Update Date | 05/17/2013
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Provider Practice Location Address
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Address Line | 2035 E BALL RD
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City | ANAHEIM
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State | CA
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Zip | 92806-5159
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Country | US
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Telephone | 714-517-6130
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Fax |
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Provider Business Mailing Address
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Address Line | 1219 E SOUTH ST
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City | ANAHEIM
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State | CA
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Zip | 92805-4817
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Country | US
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Telephone | 714-322-5901
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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 | 32367
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License Number State | CA
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