MEDICARE: GINA NABIL HAROUN

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	LCSW125687	CA
2	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1437708716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA NABIL HAROUN

Provider Business Mailing Address
First Line	:	10225 HORLEY AVE
Second Line	:
City	:	DOWNEY
State	:	CA
Zip	:	90241-2160
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3901 S WESTERN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90062-1112
Country	:	US
Telephone Number	:	323-294-0670
Fax Number	:

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

Provider Enumeration Date	:	09/09/2019
Last Update Date	:	09/08/2025

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