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NPI Code Detail

MEDICARE: MRS. CAROL ANNE STASHIK LCSW

MEDICARE: MRS. CAROL ANNE STASHIK 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 WorkerLCS16375CA

General Provider Information

NPI Number : 1750573390
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CAROL ANNE STASHIK LCSW
Provider Business Mailing Address
First Line : 550 N. FLOWER ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92703
Country : US
Telephone Number : 714-935-7131
Fax Number :
Provider Business Practice Location Address
First Line : 550 N FLOWER ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92703-2361
Country : US
Telephone Number : 714-935-7131
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2007
Last Update Date : 08/17/2007

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