MEDICARE: AMBER CARDENAS LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	61374	CA

General Provider Information

NPI Number	:	1134217227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER CARDENAS LCSW

Provider Business Mailing Address
First Line	:	3026 OREGON AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-1314
Country	:	US
Telephone Number	:	562-715-7175
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 S COMMONWEALTH AVE
Second Line	:	6TH FLOOR
City	:	LOS ANGELES
State	:	CA
Zip	:	90005-4001
Country	:	US
Telephone Number	:	213-739-5432
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	04/09/2015

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