MEDICARE: MS. JOANNA MARY SAPORITO

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	LCS18853	CA

General Provider Information

NPI Number	:	1881706059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOANNA MARY SAPORITO

Provider Business Mailing Address
First Line	:	1139 N BRAND BLVD
Second Line	:	STE. A
City	:	GLENDALE
State	:	CA
Zip	:	91202-3000
Country	:	US
Telephone Number	:	818-230-1081
Fax Number	:

Provider Business Practice Location Address
First Line	:	1139 N BRAND BLVD
Second Line	:	STE. A
City	:	GLENDALE
State	:	CA
Zip	:	91202-3000
Country	:	US
Telephone Number	:	818-230-1081
Fax Number	:

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	02/08/2012

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