Provider Demographics
NPI:1326662586
Name:CAPATI, ANNA MARIA ISABELLE MUYUELA (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNA MARIA ISABELLE
Middle Name:MUYUELA
Last Name:CAPATI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:MUYUELA
Other - Last Name:CAPATI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:59 SANCTUARY
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620
Mailing Address - Country:US
Mailing Address - Phone:714-925-0599
Mailing Address - Fax:888-507-3987
Practice Address - Street 1:59 SANCTUARY
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620
Practice Address - Country:US
Practice Address - Phone:714-925-0599
Practice Address - Fax:888-507-3987
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA289031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty