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NPI Code Detail

MEDICARE: MRS. ADRIANA MONTENEGRO BUGARIN LCSW

MEDICARE:  MRS. ADRIANA MONTENEGRO BUGARIN  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 Worker24087CA

General Provider Information

NPI Number : 1356479117
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ADRIANA MONTENEGRO BUGARIN LCSW
Provider Business Mailing Address
First Line : PO BOX 91940
Second Line :
City : PASADENA
State : CA
Zip : 91109-1940
Country : US
Telephone Number : 626-796-3453
Fax Number :
Provider Business Practice Location Address
First Line : 855 N ORANGE GROVE BLVD
Second Line :
City : PASADENA
State : CA
Zip : 91103-3333
Country : US
Telephone Number : 626-796-3453
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2007
Last Update Date : 12/06/2007

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Directions to “ MRS. ADRIANA MONTENEGRO BUGARIN LCSW” Practice Location

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