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NPI Code Detail

MEDICARE: SHADI HADDAD ASW

MEDICARE: SHADI HADDAD ASW
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 Counselor
21041C0700XClinical Social WorkerCA

General Provider Information

NPI Number : 1184878829
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHADI HADDAD ASW
Provider Business Mailing Address
First Line : 875 EL CAJON BLVD
Second Line :
City : EL CAJON
State : CA
Zip : 92020-5714
Country : US
Telephone Number : 619-662-4100
Fax Number : 619-785-3346
Provider Business Practice Location Address
First Line : 875 EL CAJON BLVD
Second Line :
City : EL CAJON
State : CA
Zip : 92020-5714
Country : US
Telephone Number : 619-662-4100
Fax Number : 619-785-3346
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2008
Last Update Date : 11/02/2023

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Directions to “ SHADI HADDAD ASW” Practice Location

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