Provider Demographics
NPI:1831267848
Name:NAJDOWSKI, THOMAS GREGORY (LCSW,MFT)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:GREGORY
Last Name:NAJDOWSKI
Suffix:
Gender:M
Credentials:LCSW,MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6110 CAMINO FORESTAL
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-6403
Mailing Address - Country:US
Mailing Address - Phone:949-218-5412
Mailing Address - Fax:
Practice Address - Street 1:12440 IMPERIAL HWY STE 116
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-8347
Practice Address - Country:US
Practice Address - Phone:800-854-7771
Practice Address - Fax:562-868-3749
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79321041C0700X
CA15508106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist