Provider Demographics
NPI:1356671846
Name:DEL GEORGE, GIA (LCSW)
Entity Type:Individual
Prefix:
First Name:GIA
Middle Name:
Last Name:DEL GEORGE
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 1:4080 CENTRE ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2657
Mailing Address - Country:US
Mailing Address - Phone:619-788-4066
Mailing Address - Fax:
Practice Address - Street 1:4080 CENTRE ST STE 202
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2657
Practice Address - Country:US
Practice Address - Phone:619-788-4066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-05
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA607651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical