MEDICARE: ARLENE TANGUILIG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	1041S0200X	School Social Worker
3	104100000X	Social Worker

General Provider Information

NPI Number	:	1316436264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARLENE TANGUILIG

Provider Business Mailing Address
First Line	:	2143 SIMON AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95122-1665
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2143 SIMON AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95122-1665
Country	:	US
Telephone Number	:	408-680-3417
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2018
Last Update Date	:	05/07/2018

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Directions to “ ARLENE TANGUILIG ” Practice Location

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