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NPI Code Detail

MEDICARE: ALYSON BIFANO LCSW

MEDICARE: ALYSON BIFANO 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 Worker25350CA

General Provider Information

NPI Number : 1447796453
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSON BIFANO LCSW
Provider Business Mailing Address
First Line : 772 QUIET HILLS FARM RD
Second Line :
City : ESCONDIDO
State : CA
Zip : 92029-7308
Country : US
Telephone Number : 530-570-1989
Fax Number :
Provider Business Practice Location Address
First Line : 772 QUIET HILLS FARM RD
Second Line :
City : ESCONDIDO
State : CA
Zip : 92029-7308
Country : US
Telephone Number : 530-570-1989
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2017
Last Update Date : 11/29/2021

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Directions to “ ALYSON BIFANO LCSW” Practice Location

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