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NPI Code Detail

MEDICARE: MRS. ANGELA NADINE SIMONEAU LCSW

MEDICARE: MRS. ANGELA NADINE SIMONEAU LCSW
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 WorkerLCS23692CA

General Provider Information

NPI Number : 1164561213
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANGELA NADINE SIMONEAU LCSW
Provider Business Mailing Address
First Line : 3177 OCEAN VIEW BLVD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92113-1432
Country : US
Telephone Number : 619-595-4400
Fax Number : 619-595-7927
Provider Business Practice Location Address
First Line : 3177 OCEAN VIEW BLVD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92113-1432
Country : US
Telephone Number : 619-595-4400
Fax Number : 619-595-7927
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2007
Last Update Date : 06/19/2008

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