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ERIN AGENJO HOHENGARTEN LCSW

>> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1376978791

Individual Registrant:
 ERIN  AGENJO HOHENGARTEN LCSW
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: --

Contact information for business:
2350 W EL CAMINO REAL FL 2  MOUNTAIN VIEW, CA 94040-6203 US
Tel: --  Fax: --

Registration Information:
NPI: 1376978791
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N101Y00000XBehavioral Health & Social Service Providers
Counselor
CA63679
N101YM0800XBehavioral Health & Social Service Providers
Counselor
CA63679
N104100000XBehavioral Health & Social Service Providers
Social Worker
CA63679
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
CA79683

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
MEDI-CAL PROVIDER GROUP NUMBER IN SANTA CRUZ COUNTYFHC 70042FCA01
COUNTY OF SANTA CRUZ MEDICARE GROUP PTAN#ZZZ91891ZCA01
COUNTY OF SANTA CRUZ MEDICARE GROUP PTAN#ZZZ91892ZCA01




HEALTH CARE JOBS CA - Page 1



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