Individual
PROF. ANTONIA TERESA AMORE-BROCCOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, L.C.S.W.
Contact information
Practice address
4300 SOQUEL DR, SPC 217, SOQUEL, CA 95073-2105
(831) 566-4409
(831) 462-2561
Mailing address
5905 SOQUEL DR, SUITE 200, SOQUEL, CA 95073-2855
(831) 566-4409
(831) 462-2561
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW 23968
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12009903
CAQH
—
01
—
1225368665
NPI
CA
Enumeration date
01/07/2010
Last updated
02/11/2022
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