Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Phillip George Tardanico, LCSW69611

Individual provider Clinical Social Worker · NPI 1063871291

Mr. Phillip George Tardanico, LCSW69611 is a Clinical Social Worker in Victorville, California. Qualified in 2002, 24 years ago. Practices with Phillip Tardanico, Licensed Clinical Social Worker and Associates, PC, a 2-clinician group and works from 3 locations. Licensed in California.

Years since qualifying
24
Licensed in
CA
In the registry since
2016
Specialties on file
2
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Practice location Address checks out

15000 Seventh St Ste 209
Victorville, CA 92395-3853
Phone: (760) 217-9527
Fax: (442) 267-5623
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1738 N Waterman Ave Ste 3, San Bernardino, CA 92404-5131 — (760) 217-9527
  • 15000 Seventh St Ste 203, Victorville, CA 92395-3851 — (760) 217-9527

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCSW69611 (CA)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence A01210315 (CA)

Record details

NPI number1063871291
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW69611
Sole proprietorNo
NPI enumeratedFebruary 16, 2016
Last updated in NPPESJune 4, 2024
Certification dateJune 4, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Phillip Tardanico, Licensed Clinical Social Worker And Associates, Pc — 2 clinicians
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Victorville