Provider Demographics
NPI:1346893872
Name:PAVONE, FRANK J (LCSW)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:J
Last Name:PAVONE
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 1:31611 WHITEDOVE LN
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-6211
Mailing Address - Country:US
Mailing Address - Phone:951-760-3206
Mailing Address - Fax:
Practice Address - Street 1:29748 RANCHO CALIFORNIA RD
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-5286
Practice Address - Country:US
Practice Address - Phone:951-252-9911
Practice Address - Fax:951-695-6215
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-23
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW879671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical