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NPI Code Detail

MEDICARE: KIMBERLY ANN IGNACIO

MEDICARE: KIMBERLY ANN IGNACIO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker113686CA

General Provider Information

NPI Number : 1124436431
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY ANN IGNACIO
Provider Business Mailing Address
First Line : 1940 E DEERE AVE STE 100
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-5718
Country : US
Telephone Number : 714-319-8212
Fax Number :
Provider Business Practice Location Address
First Line : 1940 E DEERE AVE STE 100
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-5718
Country : US
Telephone Number : 714-319-8212
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2014
Last Update Date : 02/14/2023

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Directions to “ KIMBERLY ANN IGNACIO ” Practice Location

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