Vanessa Aucella, MSW

Individual provider Active NPI Clinical Social Worker · Carson, CA

NPI 1598895401 · NPPES record last updated Jun 26, 2013

Key facts

NPI
1598895401
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
LCS 29647 (CA)
Practice address
460 E Carson Plaza Dr
Suite 122
Carson, CA 90746-3228
Phone
(310) 523-9500
Fax
(310) 225-2725
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
No

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
ASW33071CAMDMental Health Counselor
ASW 33071CAMDClinical Social Worker
ASW20097CAMDClinical Social Worker
LCS 29647CAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ASW20097 CA
Clinical Social Worker 1041C0700X ASW 33071 CA
Mental Health Counselor 101YM0800X ASW33071 CA
Clinical Social Worker 1041C0700X LCS 29647 CA Yes

Addresses

Primary practice location

460 E Carson Plaza Dr
Suite 122
Carson, CA 90746-3228

Mailing address

460 E Carson Plaza Dr
Suite 122
Carson, CA 90746-3228
Phone (310) 523-9500

Other identifiers

IdentifierTypeStateIssuer
0007300MedicaidCA

Other providers in Carson, CA

All providers in Carson, CA · Clinical Social Worker in California

Sources for this page

Verify at the official NPI Registry.