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NPI Code Detail

MEDICARE: MEGAN KRISTINA FONDREN LCSW

MEDICARE: MEGAN KRISTINA FONDREN 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
1101YM0800XMental Health CounselorCA
21041C0700XClinical Social WorkerLCSW127655CA

General Provider Information

NPI Number : 1174286223
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN KRISTINA FONDREN LCSW
Provider Business Mailing Address
First Line : 5064 VIA MANOS UNIT B
Second Line :
City : OCEANSIDE
State : CA
Zip : 92057-4530
Country : US
Telephone Number : 404-317-1573
Fax Number :
Provider Business Practice Location Address
First Line : 1300 RANCHO DEL ORO RD
Second Line :
City : OCEANSIDE
State : CA
Zip : 92056-1729
Country : US
Telephone Number : 404-317-1573
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2021
Last Update Date : 12/18/2025

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