MEDICARE: MS. WEN ER LI 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	ASW68398	CA
2	1041C0700X	Clinical Social Worker	LCSW97708	CA

General Provider Information

NPI Number	:	1649558966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. WEN ER LI LCSW

Provider Business Mailing Address
First Line	:	9353 VALLEY BLVD
Second Line	:
City	:	ROSEMEAD
State	:	CA
Zip	:	91770-1934
Country	:	US
Telephone Number	:	626-287-2988
Fax Number	:	626-287-2988

Provider Business Practice Location Address
First Line	:	320 S GARFIELD AVE STE 202
Second Line	:
City	:	ALHAMBRA
State	:	CA
Zip	:	91801-3887
Country	:	US
Telephone Number	:	626-598-3883
Fax Number	:	626-287-2988

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

Provider Enumeration Date	:	08/03/2011
Last Update Date	:	10/27/2020

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