1811762941 NPI number — MICHAEL ANNORENO LICENSED CLINICAL SOCIAL WORKER APC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811762941 NPI number — MICHAEL ANNORENO LICENSED CLINICAL SOCIAL WORKER APC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MICHAEL ANNORENO LICENSED CLINICAL SOCIAL WORKER APC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HORIZON COMMUNITY MENTAL HEALTH
Provider Other Organization Name Type Code:
3
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:
1811762941
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/20/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
39338 BEACON LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PALMDALE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93551-1089
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-810-7886
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
848 W LANCASTER BLVD STE 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93534-2347
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-441-6568
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/20/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ANNORENO
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
661-810-7886

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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