| Phillip Tardanico, Licensed Clinical Social Worker & Associates, Pc | |
|
15000 7th St Ste 209 Victorville CA 92395-3853 | |
| (760) 217-9527 | |
| (442) 267-5623 |
| Full Name | Phillip Tardanico, Licensed Clinical Social Worker & Associates, Pc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 15000 7th St Ste 209, Victorville, California |
| Authorized Official Name and Position | Phillip Tardanico (PRESIDENT/CEO) |
| Authorized Official Contact | 7602179527 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phillip Tardanico, Licensed Clinical Social Worker & Associates, Pc 15000 7th Street Suite 201 Victorville CA 92395-2463 Ph: (760) 217-9527 | Phillip Tardanico, Licensed Clinical Social Worker & Associates, Pc 15000 7th St Ste 209 Victorville CA 92395-3853 Ph: (760) 217-9527 |
| NPI Number | 1063020717 |
|---|---|
| Provider Enumeration Date | 07/20/2020 |
| Last Update Date | 11/23/2021 |
| Certification Date | 11/09/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063020717 | NPI | - | NPPES |
| 800682649 | Medicaid | CA |
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