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NPI Code Detail

MEDICARE: AMY L. STEPHEN MSW, LCSW

MEDICARE:   AMY L. STEPHEN  MSW, 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 WorkerLCS21155CA

General Provider Information

NPI Number : 1740574110
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY L. STEPHEN MSW, LCSW
Provider Business Mailing Address
First Line : 2220 CAMINO DE LA REINA
Second Line : UNIT 114
City : SAN DIEGO
State : CA
Zip : 92108-5527
Country : US
Telephone Number : 619-806-6238
Fax Number :
Provider Business Practice Location Address
First Line : 2305 MEADE AVE # 3
Second Line :
City : SAN DIEGO
State : CA
Zip : 92116-4113
Country : US
Telephone Number : 619-806-6238
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2011
Last Update Date : 06/02/2011

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Directions to “ AMY L. STEPHEN MSW, LCSW” Practice Location

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