Healthcare Provider Details

I. General information

NPI: 1083124630
Provider Name (Legal Business Name): NANCY ARANDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2017
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date: 11/17/2022
Reactivation Date: 11/28/2022

III. Provider practice location address

333 S BEAUDRY AVE
LOS ANGELES CA
90017-1466
US

IV. Provider business mailing address

333 S BEAUDRY AVE
LOS ANGELES CA
90017-1466
US

V. Phone/Fax

Practice location:
  • Phone: 213-241-3841
  • Fax: 213-241-3305
Mailing address:
  • Phone: 213-241-3841
  • Fax: 213-241-3305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number105160
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: