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General NPI Number Information
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NPI Number | 1841031531
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Entity Type | Organization
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Legal Business Name | STEPHANIE FLORES LICENSED CLINICAL SOCIAL WORKER INC.
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 06/29/2024
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Provider Practice Location Address
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Address Line | 14751 PLAZA DR STE C
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City | TUSTIN
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State | CA
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Zip | 92780-2773
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Country | US
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Telephone | 714-300-8063
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Fax |
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Provider Business Mailing Address
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Address Line | 14751 PLAZA DR STE C
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City | TUSTIN
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State | CA
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Zip | 92780-2773
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Country | US
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Telephone | 714-300-8063
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | STEPHANIE FLORES
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Credential | LCSW
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Telephone | 714-300-8063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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