Provider Demographics
NPI:1083185383
Name:PROFIT, FELICIA ISABEL (MSW, ASW)
Entity type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:ISABEL
Last Name:PROFIT
Suffix:
Gender:F
Credentials:MSW, ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24904 SHOSHONE DR
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5826
Mailing Address - Country:US
Mailing Address - Phone:858-205-4250
Mailing Address - Fax:
Practice Address - Street 1:24904 SHOSHONE DR
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5826
Practice Address - Country:US
Practice Address - Phone:858-205-4250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-12
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA1007561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health