Provider Demographics
NPI:1811196462
Name:GLASSMAN, JUDITH A (LCSW)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:A
Last Name:GLASSMAN
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 1:10978 W OCEAN AIR DR
Mailing Address - Street 2:#3115
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-4670
Mailing Address - Country:US
Mailing Address - Phone:858-605-0970
Mailing Address - Fax:
Practice Address - Street 1:505 LOMAS SANTA FE DR
Practice Address - Street 2:SUITE 260
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1333
Practice Address - Country:US
Practice Address - Phone:858-279-1223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 230231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical