Healthcare Provider Details

I. General information

NPI: 1982986352
Provider Name (Legal Business Name): DORIS NG ROBERTSON LCSW, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DORIS WEI-CEE NG MSW, MPH

II. Dates (important events)

Enumeration Date: 09/12/2011
Last Update Date: 06/14/2021
Certification Date: 06/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1119 S CITRUS AVE APT 2
LOS ANGELES CA
90019-1644
US

IV. Provider business mailing address

1119 S CITRUS AVE APT 2
LOS ANGELES CA
90019-1644
US

V. Phone/Fax

Practice location:
  • Phone: 310-701-6732
  • Fax:
Mailing address:
  • Phone: 310-701-6732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number70128
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: