Provider Demographics
NPI:1497300693
Name:REPRODUCTIVE MENTAL HEALTH AND WELLNESS LICENSED CLINICAL SOCIAL WORKE
Entity Type:Organization
Organization Name:REPRODUCTIVE MENTAL HEALTH AND WELLNESS LICENSED CLINICAL SOCIAL WORKE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:REMBA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:858-367-3622
Mailing Address - Street 1:11440 W BERNARDO CT STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-1644
Mailing Address - Country:US
Mailing Address - Phone:858-380-2600
Mailing Address - Fax:858-367-6160
Practice Address - Street 1:11440 W BERNARDO CT STE 300
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1644
Practice Address - Country:US
Practice Address - Phone:858-380-2600
Practice Address - Fax:858-367-6160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-05
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty