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NPI Code Detail

MEDICARE: MS. CARRIE KINTZ LCSW

MEDICARE: MS. CARRIE KINTZ 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 WorkerLCS21791CA

General Provider Information

NPI Number : 1265588305
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CARRIE KINTZ LCSW
Provider Business Mailing Address
First Line : 2311 ILLION ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-2344
Country : US
Telephone Number : 858-688-2485
Fax Number :
Provider Business Practice Location Address
First Line : 3002 ARMSTRONG ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-5702
Country : US
Telephone Number : 858-688-2485
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2007
Last Update Date : 06/24/2011

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Directions to “ MS. CARRIE KINTZ LCSW” Practice Location

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