Healthcare Provider Details

I. General information

NPI: 1730545161
Provider Name (Legal Business Name): DARA CAFIERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2016
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 W REDONDO BEACH BLVD
GARDENA CA
90247-4128
US

IV. Provider business mailing address

655 MAPLE AVE
LOS ANGELES CA
90014-2211
US

V. Phone/Fax

Practice location:
  • Phone: 213-865-2603
  • Fax:
Mailing address:
  • Phone: 310-940-4866
  • Fax: 213-241-3305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW126631
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: