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NPI Code Detail

MEDICARE: TORI DANG LCSW

MEDICARE: TORI DANG 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 Worker102040CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578913760
Entity Type Code : Individual
Provider Name (Legal Business Name) : TORI DANG LCSW
Provider Business Mailing Address
First Line : 9245 TWIN TRAILS DR UNIT 720084
Second Line :
City : SAN DIEGO
State : CA
Zip : 92172-7005
Country : US
Telephone Number : 909-312-4809
Fax Number :
Provider Business Practice Location Address
First Line : 560 E HOSPITALITY LN STE 330
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92408-3546
Country : US
Telephone Number : 888-588-8995
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2016
Last Update Date : 08/02/2023

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