MEDICARE: ALIYA LECOVER

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	136170	CA

General Provider Information

NPI Number	:	1730648643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALIYA LECOVER

Provider Business Mailing Address
First Line	:	4972 1/2 CAPE MAY AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92107-2526
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4972 1/2 CAPE MAY AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92107-2526
Country	:	US
Telephone Number	:	805-709-4131
Fax Number	:

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

Provider Enumeration Date	:	03/19/2019
Last Update Date	:	01/20/2026

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