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1582 W San Marcos Blvd Ste 105 San Marcos CA 92078-4081 | |
| (760) 522-7158 | |
| (760) 539-7357 |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1582 W San Marcos Blvd Ste 105, San Marcos, California |
| Authorized Official Name and Position | Carolyn Bowe-mcleod (BILLING MANAGER) |
| Authorized Official Contact | 7604337944 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1582 W San Marcos Blvd Ste 105 San Marcos CA 92078-4081 Ph: (760) 522-7158 | 1582 W San Marcos Blvd Ste 105 San Marcos CA 92078-4081 Ph: (760) 522-7158 |
| NPI Number | 1740779164 |
|---|---|
| Provider Enumeration Date | 05/02/2018 |
| Last Update Date | 02/17/2023 |
| Certification Date | 06/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740779164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 27130 (California) | Primary |
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