MEDICARE: MISS JENNIFER ANN DE FRANCISCO L.C.S.W.

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
1	1041C0700X	Clinical Social Worker	LCS22174	CA

General Provider Information

NPI Number	:	1386651107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JENNIFER ANN DE FRANCISCO L.C.S.W.

Provider Business Mailing Address
First Line	:	1601 DOVE ST
Second Line	:	SUITE 292
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-2433
Country	:	US
Telephone Number	:	949-251-8797
Fax Number	:	949-752-6448

Provider Business Practice Location Address
First Line	:	1601 DOVE ST
Second Line	:	SUITE 292
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-2433
Country	:	US
Telephone Number	:	949-251-8797
Fax Number	:	949-752-6448

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

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	07/08/2007

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