Provider Demographics
NPI:1114025269
Name:BIAL, VIRGINIA DILLON (LCSW)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:DILLON
Last Name:BIAL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:GINGER
Other - Middle Name:DILLON
Other - Last Name:BIAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:3020 CHILDRENS WAY # MC5018
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4223
Mailing Address - Country:US
Mailing Address - Phone:858-576-8236
Mailing Address - Fax:
Practice Address - Street 1:5650 MOUNT ACKERLY DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-4016
Practice Address - Country:US
Practice Address - Phone:858-576-8236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS22026104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker