Healthcare Provider Details

I. General information

NPI: 1609101971
Provider Name (Legal Business Name): SALLY RODAS CURRAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SALLY RODAS

II. Dates (important events)

Enumeration Date: 10/05/2009
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 MAIN ST # 110
EL SEGUNDO CA
90245-3803
US

IV. Provider business mailing address

214 MAIN ST # 110
EL SEGUNDO CA
90245-3803
US

V. Phone/Fax

Practice location:
  • Phone: 202-321-3949
  • Fax:
Mailing address:
  • Phone: 202-321-3949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number65552
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: