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General NPI Number Information
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NPI Number | 1922359413
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Entity Type | Individual
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Provider Name | LETICIA ITEN
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Gender | Female
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Dates
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Enumeration Date | 09/25/2012
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Last Update Date | 03/02/2022
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Provider Practice Location Address
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Address Line | 444 S 8TH ST STE B3
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City | EL CENTRO
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State | CA
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Zip | 92243-3236
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Country | US
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Telephone | 760-353-6571
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Fax | 760-353-6281
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Provider Business Mailing Address
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Address Line | PO BOX 513
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City | EL CENTRO
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State | CA
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Zip | 92244-0513
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Country | US
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Telephone | 760-353-6571
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Fax | 760-353-6281
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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 | ASW86884
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License Number State | CA
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