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General NPI Number Information
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NPI Number | 1982432456
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Entity Type | Individual
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Provider Name | ANGIE AQUINO ASW
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Gender | Female
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Dates
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Enumeration Date | 07/25/2024
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 1654 BUCKMAN SPRINGS RD
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City | CAMPO
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State | CA
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Zip | 91906-2004
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Country | US
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Telephone | 619-478-5583
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Fax |
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Provider Business Mailing Address
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Address Line | 621 CADMAN ST
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City | SAN DIEGO
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State | CA
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Zip | 92114-3213
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Country | US
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Telephone | 619-717-1570
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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 | 325639
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License Number State | CA
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