Provider Demographics
NPI:1962197640
Name:BOJORQUEZ, WENDY
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:BOJORQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8775 AERO DR STE 240
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1756
Mailing Address - Country:US
Mailing Address - Phone:619-304-4852
Mailing Address - Fax:
Practice Address - Street 1:8775 AERO DR STE 240
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1756
Practice Address - Country:US
Practice Address - Phone:619-304-4852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1109311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical