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ERIN AGENJO HOHENGARTEN LCSW
>> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1376978791
Individual Registrant: ERIN AGENJO HOHENGARTEN LCSW
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
2025 SOQUEL AVE SANTA CRUZ, CA 95062-1323 US
Tel: 831-458-4888 Fax: --
Tel: 831-458-4888 Fax: --
Contact information for business:
2350 W EL CAMINO REAL FL 2 MOUNTAIN VIEW, CA 94040-6203 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1376978791
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 101Y00000X | Behavioral Health & Social Service Providers Counselor | CA | 63679 |
| N | 101YM0800X | Behavioral Health & Social Service Providers Counselor | CA | 63679 |
| N | 104100000X | Behavioral Health & Social Service Providers Social Worker | CA | 63679 |
| Y | 1041C0700X | Behavioral Health & Social Service Providers Social Worker | CA | 79683 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| MEDI-CAL PROVIDER GROUP NUMBER IN SANTA CRUZ COUNTY | FHC 70042F | CA | 01 |
| COUNTY OF SANTA CRUZ MEDICARE GROUP PTAN# | ZZZ91891Z | CA | 01 |
| COUNTY OF SANTA CRUZ MEDICARE GROUP PTAN# | ZZZ91892Z | CA | 01 |
