Healthcare Provider Details

I. General information

NPI: 1912170754
Provider Name (Legal Business Name): MARLENE CHROMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2008
Last Update Date: 04/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9400 ROSECRANS AVE MODULE 3700
BELLFLOWER CA
90706-2246
US

IV. Provider business mailing address

5625 CRESCENT PARK W UNIT 313
PLAYA VISTA CA
90094-2079
US

V. Phone/Fax

Practice location:
  • Phone: 562-461-6542
  • Fax: 562-461-6533
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS15833
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: