Basic Information
| Provider Information | |||||||||
| NPI: | 1144366113 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PHONGBOUPHA ALMONDIA | ||||||||
| FirstName: | SOMCHITH | ||||||||
| MiddleName: | |||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13585 SAN PABLO AVE. | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | SAN PABLO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5109424700 | ||||||||
| FaxNumber: | 5109424776 | ||||||||
| Practice Location | |||||||||
| Address1: | 13585 SAN PABLO AVE. | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | SAN PABLO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5109424700 | ||||||||
| FaxNumber: | 5109424776 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2007 | ||||||||
| LastUpdateDate: | 02/26/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | ASW 14951 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.