Basic Information
| Provider Information | |||||||||
| NPI: | 1346893872 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PAVONE | ||||||||
| FirstName: | FRANK | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 31611 WHITEDOVE LN | ||||||||
| Address2: | |||||||||
| City: | MURRIETA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925636211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9517603206 | ||||||||
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| Practice Location | |||||||||
| Address1: | 29748 RANCHO CALIFORNIA RD | ||||||||
| Address2: | |||||||||
| City: | TEMECULA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925915286 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9512529911 | ||||||||
| FaxNumber: | 9516956215 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2019 | ||||||||
| LastUpdateDate: | 09/17/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LCSW87967 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.