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NPI Code Detail

MEDICARE: MS. ANNA ZOE WEITZ LCSW

MEDICARE: MS. ANNA ZOE WEITZ 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 Worker79515CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
179515OTHERCABOARD OF BEHAVIORAL SCIENCES

General Provider Information

NPI Number : 1376055889
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANNA ZOE WEITZ LCSW
Provider Business Mailing Address
First Line : 2851 CAMINO DEL RIO S STE 300
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-3814
Country : US
Telephone Number : 619-550-8477
Fax Number :
Provider Business Practice Location Address
First Line : 2851 CAMINO DEL RIO S STE 300
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-3814
Country : US
Telephone Number : 619-550-8477
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2017
Last Update Date : 01/13/2021

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