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NPI Code Detail

MEDICARE: MS. HOLLY ANN HOUSE LCSW

MEDICARE: MS. HOLLY ANN HOUSE 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 WorkerLCS 24153CA

General Provider Information

NPI Number : 1477739621
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. HOLLY ANN HOUSE LCSW
Provider Business Mailing Address
First Line : 1094 CUDAHY PL STE 314
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-3924
Country : US
Telephone Number : 619-276-8112
Fax Number : 619-276-8230
Provider Business Practice Location Address
First Line : 1094 CUDAHY PL STE 314
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-3924
Country : US
Telephone Number : 619-276-8112
Fax Number : 619-276-8230
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2008
Last Update Date : 01/18/2008

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Directions to “ MS. HOLLY ANN HOUSE LCSW” Practice Location

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