Healthcare Provider Details

I. General information

NPI: 1316823701
Provider Name (Legal Business Name): TRACY TAMARA CERDA ARMENTA LCSW, PPSC, CWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11627 BROOKSHIRE AVE
DOWNEY CA
90241-4911
US

IV. Provider business mailing address

11627 BROOKSHIRE AVE
DOWNEY CA
90241-4911
US

V. Phone/Fax

Practice location:
  • Phone: 562-469-6500
  • Fax:
Mailing address:
  • Phone: 562-469-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number101309
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: