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Individual

ESTHER MATA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
390 N LOOP RD, FORT IRWIN, CA 92310
(760) 383-5440
Mailing address
390 N LOOP RD, FORT IRWIN, CA 92310

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9905-C
NJ
104100000X
Social Worker
Primary
9905-C
NV

Other

Enumeration date
12/30/2019
Last updated
07/31/2026
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