Provider Demographics
NPI:1932277597
Name:AIDAR-CURRIER, RENATA K (LCSW)
Entity Type:Individual
Prefix:
First Name:RENATA
Middle Name:K
Last Name:AIDAR-CURRIER
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 1:3535 MADISON AVE UNIT 231
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-5516
Mailing Address - Country:US
Mailing Address - Phone:619-804-6918
Mailing Address - Fax:619-528-4625
Practice Address - Street 1:625 3RD AVE
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-5703
Practice Address - Country:US
Practice Address - Phone:619-804-6918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26063104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW416Medicare PIN
CACX212ZMedicare PIN