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NPI Code Detail

MEDICARE: MS. MIRTALA PARADA WARD LCSW

MEDICARE: MS. MIRTALA PARADA WARD 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
11041C0700XClinical Social Worker22106CA

General Provider Information

NPI Number : 1578646790
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MIRTALA PARADA WARD LCSW
Provider Business Mailing Address
First Line : 330 E LIVE OAK AVE
Second Line :
City : ARCADIA
State : CA
Zip : 91006-5617
Country : US
Telephone Number : 626-821-5858
Fax Number : 626-821-0858
Provider Business Practice Location Address
First Line : 330 E LIVE OAK AVE
Second Line :
City : ARCADIA
State : CA
Zip : 91006-5617
Country : US
Telephone Number : 626-821-5858
Fax Number : 626-821-0858
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2006
Last Update Date : 07/08/2007

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