Provider Demographics
NPI:1144366113
Name:PHONGBOUPHA ALMONDIA, SOMCHITH (LCSW)
Entity type:Individual
Prefix:
First Name:SOMCHITH
Middle Name:
Last Name:PHONGBOUPHA ALMONDIA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13585 SAN PABLO AVE.
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806
Mailing Address - Country:US
Mailing Address - Phone:510-942-4700
Mailing Address - Fax:510-942-4776
Practice Address - Street 1:13585 SAN PABLO AVE.
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806
Practice Address - Country:US
Practice Address - Phone:510-942-4700
Practice Address - Fax:510-942-4776
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 149511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical