1447366752 NPI number — ANNE THERESE CHICOINE M.S.W L.C.S.W.

Table of content: ANNE THERESE CHICOINE M.S.W L.C.S.W. (NPI 1447366752)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447366752 NPI number — ANNE THERESE CHICOINE M.S.W L.C.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHICOINE
Provider First Name:
ANNE
Provider Middle Name:
THERESE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S.W L.C.S.W.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447366752
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
44199 MONROE ST STE C
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDIO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92201-3094
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-863-2907
Provider Business Mailing Address Fax Number:
760-863-2943

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
44199 MONROE ST STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92201-3094
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-863-2907
Provider Business Practice Location Address Fax Number:
760-863-2943
Provider Enumeration Date:
08/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LCS 21634 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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