Provider Demographics
NPI:1932484342
Name:STRATAGEMA, A LICENSED CLINICAL SOCIAL WORKER CORP
Entity Type:Organization
Organization Name:STRATAGEMA, A LICENSED CLINICAL SOCIAL WORKER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:C
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:619-694-8994
Mailing Address - Street 1:1428 FILMORE PL
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-1820
Mailing Address - Country:US
Mailing Address - Phone:619-694-8994
Mailing Address - Fax:
Practice Address - Street 1:2160 FLETCHER PKWY
Practice Address - Street 2:SUITE M
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-2139
Practice Address - Country:US
Practice Address - Phone:619-694-8994
Practice Address - Fax:619-562-2584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS223631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty