Facts
- Status
- A
- Credential
- LCSW
- Type
- Individual
- Enumeration date
- 2014-09-23
- Last updated
- 2020-06-18
Specialties
Licenses
- License CA
- LCSW85839
Location
- Practice location
- 13173 OSBORNE ST
- City
- ARLETA CA
- Postal code
- 913314019
- Phone
- 818-473-9818
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.