Provider Demographics
NPI:1184659989
Name:FEUERBORN, WILLIAM EDWARD (LCSW)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EDWARD
Last Name:FEUERBORN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17744 SKY PARK CIR STE 210
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-4481
Mailing Address - Country:US
Mailing Address - Phone:760-285-9888
Mailing Address - Fax:
Practice Address - Street 1:17744 SKY PARK CIR STE 210
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-4481
Practice Address - Country:US
Practice Address - Phone:760-285-9888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS208131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical