Provider Demographics
NPI:1366737033
Name:FAWSON, SYLVIA (LMSW)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:FAWSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34800 BOB WILSON DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134-3902
Mailing Address - Country:US
Mailing Address - Phone:619-524-9356
Mailing Address - Fax:
Practice Address - Street 1:34800 BOB WILSON DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-3902
Practice Address - Country:US
Practice Address - Phone:619-524-9356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman