Healthcare Provider Details

I. General information

NPI: 1528463544
Provider Name (Legal Business Name): ALEJANDRA ROMO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2014
Last Update Date: 02/22/2023
Certification Date: 02/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 W OLYMPIC BLVD STE 600
LOS ANGELES CA
90015-3865
US

IV. Provider business mailing address

1625 W OLYMPIC BLVD STE 600
LOS ANGELES CA
90015-3865
US

V. Phone/Fax

Practice location:
  • Phone: 323-999-2404
  • Fax:
Mailing address:
  • Phone: 323-999-2404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number67426
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCSW101593
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW67426
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW101593
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: