Provider Demographics
NPI:1114948908
Name:ENCINIAS, GUADALUPITA (LMSW-CADC II)
Entity Type:Individual
Prefix:MS
First Name:GUADALUPITA
Middle Name:
Last Name:ENCINIAS
Suffix:
Gender:F
Credentials:LMSW-CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1295
Mailing Address - Street 2:
Mailing Address - City:BARSTOW
Mailing Address - State:CA
Mailing Address - Zip Code:92312-1295
Mailing Address - Country:US
Mailing Address - Phone:760-380-4032
Mailing Address - Fax:
Practice Address - Street 1:MCXK-ADP, BLDG 170
Practice Address - Street 2:RM 515
Practice Address - City:FORT IRWIN
Practice Address - State:CA
Practice Address - Zip Code:92310
Practice Address - Country:US
Practice Address - Phone:760-380-4074
Practice Address - Fax:760-380-6469
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801069958104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker