Rose Kathleen Andrade, LCSW

Individual provider Active NPI Clinical Social Worker · Apple Valley, CA

NPI 1104178532 · NPPES record last updated Aug 13, 2013

Key facts

NPI
1104178532
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
29464 (CA)
Practice address
17800 US Highway 18
Apple Valley, CA 92307-1221
Phone
(760) 246-6336
Fax
(760) 946-0819
NPI assigned
Oct 9, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
29464CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
San Bernardino County Superintendent of Schools Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 29464 CA Yes

Addresses

Primary practice location

17800 US Highway 18
Apple Valley, CA 92307-1221

Mailing address

17800 US Highway 18
Apple Valley, CA 92307-1221
Phone (760) 246-6336

Other providers in Apple Valley, CA

All providers in Apple Valley, CA · Clinical Social Worker in California

Sources for this page

Verify at the official NPI Registry.