Provider Demographics
NPI:1649743717
Name:MOLKNER, ILANA (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:ILANA
Middle Name:
Last Name:MOLKNER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:ILANA
Other - Middle Name:
Other - Last Name:TERES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPH
Mailing Address - Street 1:3830 VALLEY CENTRE DR
Mailing Address - Street 2:STE 705 PMB 813
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-3320
Mailing Address - Country:US
Mailing Address - Phone:858-342-9286
Mailing Address - Fax:
Practice Address - Street 1:1337 CAMINO DEL MAR STE B
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-2504
Practice Address - Country:US
Practice Address - Phone:858-342-9286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1024001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical