Provider Demographics
NPI:1659321784
Name:CLARKIN-WATTS, ANNE ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:ELIZABETH
Last Name:CLARKIN-WATTS
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 1:3110 CAMINO DEL RIO S
Mailing Address - Street 2:#219
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3812
Mailing Address - Country:US
Mailing Address - Phone:619-525-3595
Mailing Address - Fax:858-566-6321
Practice Address - Street 1:3110 CAMINO DEL RIO S
Practice Address - Street 2:#219
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3812
Practice Address - Country:US
Practice Address - Phone:619-525-3595
Practice Address - Fax:858-566-6321
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS126041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW12604Medicare ID - Type Unspecified