MEDICARE: CLAUDIA LANDAVERDE ASW

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	330417	CA
2	1041S0200X	School Social Worker
3	106S00000X	Behavior Technician
4	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1396637088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDIA LANDAVERDE ASW

Provider Business Mailing Address
First Line	:	1308 E COLORADO BLVD # 2318
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-1932
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1308 E COLORADO BLVD # 2318
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-1932
Country	:	US
Telephone Number	:	626-877-2258
Fax Number	:

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

Provider Enumeration Date	:	07/17/2025
Last Update Date	:	07/21/2025

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