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Individual
ERIN AGENJO HOHENGARTEN
Active
Individual
ERIN AGENJO HOHENGARTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
63679
CA
101YM0800X
Mental Health Counselor
63679
CA
104100000X
Social Worker
63679
CA
1041C0700X
Clinical Social Worker
Primary
79683
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FHC 70042F
MEDI-CAL PROVIDER GROUP NUMBER IN SANTA CRUZ COUNTY
CA
01
—
ZZZ91891Z
COUNTY OF SANTA CRUZ MEDICARE GROUP PTAN#
CA
01
—
ZZZ91892Z
COUNTY OF SANTA CRUZ MEDICARE GROUP PTAN#
CA
Enumeration date
09/04/2013
Last updated
05/01/2019
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