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NPI Code Detail

MEDICARE: MRS. CHRISTINA MARIE NAKANISHI LCSW

MEDICARE:  MRS. CHRISTINA MARIE NAKANISHI  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 WorkerLCS# 29601CA

General Provider Information

NPI Number : 1962844233
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISTINA MARIE NAKANISHI LCSW
Provider Business Mailing Address
First Line : 10805 OLIVIA WAY
Second Line :
City : SAN DIEGO
State : CA
Zip : 92129-2015
Country : US
Telephone Number : 619-398-6149
Fax Number :
Provider Business Practice Location Address
First Line : 10805 OLIVIA WAY
Second Line :
City : SAN DIEGO
State : CA
Zip : 92129-2015
Country : US
Telephone Number : 619-398-6149
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2013
Last Update Date : 06/06/2022

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Directions to “ MRS. CHRISTINA MARIE NAKANISHI LCSW” Practice Location

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