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NPI Code Detail

MEDICARE: BAILEY HANA IWAMOTO LCSW

MEDICARE: BAILEY HANA IWAMOTO 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 Worker139677CA

General Provider Information

NPI Number : 1396671582
Entity Type Code : Individual
Provider Name (Legal Business Name) : BAILEY HANA IWAMOTO LCSW
Provider Business Mailing Address
First Line : 11251 RANCHO CARMEL DR UNIT 502841
Second Line :
City : SAN DIEGO
State : CA
Zip : 92150-8115
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4647 ZION AVE RM 2145
Second Line :
City : SAN DIEGO
State : CA
Zip : 92120-2507
Country : US
Telephone Number : 619-528-5541
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2026
Last Update Date : 06/23/2026

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