Healthcare Provider Details

I. General information

NPI: 1346904778
Provider Name (Legal Business Name): ADELANTE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2021
Last Update Date: 10/22/2021
Certification Date: 10/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 S EASTERN AVE STE 500
COMMERCE CA
90040-4033
US

IV. Provider business mailing address

5800 S EASTERN AVE STE 500
COMMERCE CA
90040-4033
US

V. Phone/Fax

Practice location:
  • Phone: 323-333-3305
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ESMERALDA LEDESMA
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: MSW
Phone: 323-333-3305