MEDICARE: ZIVA DOSHI LCSW, OSW-C

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	104100000X	Social Worker	P89183	NY
2	1041C0700X	Clinical Social Worker	73560	CA

General Provider Information

NPI Number	:	1962843953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZIVA DOSHI LCSW, OSW-C

Provider Business Mailing Address
First Line	:	PO BOX 6545
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92863-6545
Country	:	US
Telephone Number	:	424-625-8783
Fax Number	:

Provider Business Practice Location Address
First Line	:	12300 WILSHIRE BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-1020
Country	:	US
Telephone Number	:	424-625-8783
Fax Number	:

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

Provider Enumeration Date	:	07/08/2013
Last Update Date	:	08/20/2021

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