MEDICARE: MS. KAREN NMN ACCARDO-BAQUERO L.C.S.W.

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	1041C0700X	Clinical Social Worker	LCS 15116	CA
2	104100000X	Social Worker	LCS 15116	CA

General Provider Information

NPI Number	:	1669573903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN NMN ACCARDO-BAQUERO L.C.S.W.

Provider Business Mailing Address
First Line	:	11858 BERNARDO PLAZA CT
Second Line	:	SUITE 210
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-2439
Country	:	US
Telephone Number	:	760-505-1712
Fax Number	:	858-592-1495

Provider Business Practice Location Address
First Line	:	11858 BERNARDO PLAZA CT
Second Line	:	SUITE 210
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-2439
Country	:	US
Telephone Number	:	760-505-1712
Fax Number	:	858-592-1495

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

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	01/13/2014

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