Healthcare Provider Details

I. General information

NPI: 1609239250
Provider Name (Legal Business Name): ERIN WURTEMBERG MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2016
Last Update Date: 08/24/2024
Certification Date: 08/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 7453
ALHAMBRA CA
91802-7453
US

IV. Provider business mailing address

PO BOX 7453
ALHAMBRA CA
91802-7453
US

V. Phone/Fax

Practice location:
  • Phone: 213-241-3841
  • Fax: 213-241-3305
Mailing address:
  • Phone: 626-386-3541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number86747
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW86747
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: