MEDICARE: DEISI ROHSIG-MOESER 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	101YM0800X	Mental Health Counselor	ASW 63322	CA
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1285069658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEISI ROHSIG-MOESER LCSW

Provider Business Mailing Address
First Line	:	1920 HILLHURST AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-2712
Country	:	US
Telephone Number	:	310-592-3982
Fax Number	:

Provider Business Practice Location Address
First Line	:	1920 HILLHURST AVE
Second Line	:	STE 1180
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-2712
Country	:	US
Telephone Number	:	310-592-3982
Fax Number	:

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

Provider Enumeration Date	:	09/04/2013
Last Update Date	:	06/06/2021

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