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NPI Code Detail

MEDICARE: MRS. HAZEL EARLEEN ARETAKIS LCSW

MEDICARE:  MRS. HAZEL EARLEEN ARETAKIS  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 CounselorLCS 21114CA

General Provider Information

NPI Number : 1235120189
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HAZEL EARLEEN ARETAKIS LCSW
Provider Business Mailing Address
First Line : PO BOX 555191
Second Line : NAVAL HOSPITAL CAMP PENDLETON
City : CAMP PENDLETON
State : CA
Zip : 92055-5191
Country : US
Telephone Number : 760-725-1555
Fax Number :
Provider Business Practice Location Address
First Line : NAVEL HOSPITAL CAMP PENDLETON
Second Line : H100 SANTA MARGURITA RD
City : OCEANSIDE
State : CA
Zip : 92055-5191
Country : US
Telephone Number : 760-725-1555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2005
Last Update Date : 06/02/2009

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Directions to “ MRS. HAZEL EARLEEN ARETAKIS LCSW” Practice Location

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