Provider Demographics
NPI:1275653966
Name:CONTRERAS, LUIS ALBERTO (LCSW)
Entity Type:Individual
Prefix:MR
First Name:LUIS
Middle Name:ALBERTO
Last Name:CONTRERAS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3065 BEYER BLVD, SUITE B-103
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154
Mailing Address - Country:US
Mailing Address - Phone:619-271-7748
Mailing Address - Fax:619-271-7982
Practice Address - Street 1:3065 BEYER BLVD, SUITE B-103
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-3263
Practice Address - Country:US
Practice Address - Phone:619-271-7748
Practice Address - Fax:619-271-7982
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27820104100000X
CA814461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA104100000XOtherSOCIAL WORKER