MEDICARE: MS. PAULINE PATRICIA WARD L.C.S.W.

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	LCS15109	CA

General Provider Information

NPI Number	:	1518163229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PAULINE PATRICIA WARD L.C.S.W.

Provider Business Mailing Address
First Line	:	275 CLIPPER WAY
Second Line	:
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-5955
Country	:	US
Telephone Number	:	562-431-6158
Fax Number	:

Provider Business Practice Location Address
First Line	:	3801 E WILLOW ST
Second Line	:	JEWISH FAMILY & CHILDREN SERVICES
City	:	LONG BEACH
State	:	CA
Zip	:	90815-1734
Country	:	US
Telephone Number	:	562-427-7916
Fax Number	:	562-427-7910

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

Provider Enumeration Date	:	06/21/2007
Last Update Date	:	07/08/2007

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