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Individual
EDGAR CAMPUGAN
Active
Individual
EDGAR CAMPUGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
109714
CA
1041C0700X
Clinical Social Worker
Primary
109714
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109714
BBS ACSW LICENSE NUMBER
CA
Enumeration date
08/29/2022
Last updated
06/27/2023
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