Provider Demographics
NPI:1902990724
Name:SAN GIOVANNI, FRANK (LISW)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:
Last Name:SAN GIOVANNI
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 SANTA FE AVE SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-4163
Mailing Address - Country:US
Mailing Address - Phone:505-977-1988
Mailing Address - Fax:505-244-0554
Practice Address - Street 1:4011 BARBARA LOOP SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1039
Practice Address - Country:US
Practice Address - Phone:505-891-1583
Practice Address - Fax:505-891-1768
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-04481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical