Healthcare Provider Details

I. General information

NPI: 1780847293
Provider Name (Legal Business Name): BELINDA CRISTAL NUNEZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2008
Last Update Date: 01/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 E CESAR E CHAVEZ AVE
LOS ANGELES CA
90022-1209
US

IV. Provider business mailing address

2817 E VALLEY BLVD APT 3J
WEST COVINA CA
91792-3142
US

V. Phone/Fax

Practice location:
  • Phone: 323-881-3799
  • Fax:
Mailing address:
  • Phone: 323-244-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberACSW 23858
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW 74871
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: