Basic Information
| Provider Information | |||||||||
| NPI: | 1952573479 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OCHOA LEWIS | ||||||||
| FirstName: | ANJELICA | ||||||||
| MiddleName: | TETZIL | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | L.C.S.W. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3665 KEARNY VILLA RD. STE. 101 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8589665832 | ||||||||
| FaxNumber: | 8589666733 | ||||||||
| Practice Location | |||||||||
| Address1: | 3665 KEARNY VILLA RD STE 101 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921231954 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8589665832 | ||||||||
| FaxNumber: | 8589666733 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2008 | ||||||||
| LastUpdateDate: | 07/16/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | ASW 28739 | CA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 1041C0700X | ASW 17053 | CA | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | LCSW 27994 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.