MEDICARE: MS. VINCA ACUNA MSW

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	ASW 12088	CA

General Provider Information

NPI Number	:	1760516157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VINCA ACUNA MSW

Provider Business Mailing Address
First Line	:	3711 LONG BEACH BLVD
Second Line	:	SUITE 600
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3315
Country	:	US
Telephone Number	:	562-216-2174
Fax Number	:	562-981-7569

Provider Business Practice Location Address
First Line	:	3711 LONG BEACH BLVD
Second Line	:	SUITE 600
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3315
Country	:	US
Telephone Number	:	562-216-2174
Fax Number	:	562-981-7569

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

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	07/08/2007

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