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AUDREY YVONNE CORDOVA LCSW
Clinical >> Social Worker >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1366566770
Individual Registrant: AUDREY YVONNE CORDOVA LCSW
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
650 LIGHTHOUSE AVE STE 200 PACIFIC GROVE, CA 93950-2674 US
Tel: 831-293-7833 Fax: 831-208-3836
Tel: 831-293-7833 Fax: 831-208-3836
Contact information for business:
1311 SHAFTER AVE PACIFIC GROVE, CA 93950-5528 US
Tel: 831-293-7833 Fax: 831-208-3836
Tel: 831-293-7833 Fax: 831-208-3836
Registration Information:
NPI: 1366566770
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1041C0700X | Behavioral Health & Social Service Providers Social Worker Clinical | CA | LCS24424 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
