MEDICARE: MIREADE MCCALLEN

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	1041S0200X	School Social Worker	LCSW21259	CA

General Provider Information

NPI Number	:	1568321602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIREADE MCCALLEN

Provider Business Mailing Address
First Line	:	6889 EL FUERTE ST
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92009-5923
Country	:	US
Telephone Number	:	760-290-2121
Fax Number	:	760-290-2120

Provider Business Practice Location Address
First Line	:	6889 EL FUERTE ST
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92009-5923
Country	:	US
Telephone Number	:	760-290-2121
Fax Number	:	760-290-2120

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

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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Directions to “ MIREADE MCCALLEN ” Practice Location

Language	Start Address	Practice Location

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