Provider Demographics
NPI:1326442708
Name:MATTHEWS, DELORIS VIVIAN (LCSW)
Entity Type:Individual
Prefix:
First Name:DELORIS
Middle Name:VIVIAN
Last Name:MATTHEWS
Suffix:
Gender:F
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:PO BOX 7162
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92658-7162
Mailing Address - Country:US
Mailing Address - Phone:949-375-0118
Mailing Address - Fax:
Practice Address - Street 1:7303 PINTADO
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-0231
Practice Address - Country:US
Practice Address - Phone:949-375-0118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-14
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW623911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical