Healthcare Provider Details

I. General information

NPI: 1386734895
Provider Name (Legal Business Name): DAWN E URASAKI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 02/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W 1ST ST 6TH FLOOR
LOS ANGELES CA
90012-4112
US

IV. Provider business mailing address

550 S VERMONT AVE 10TH FLOOR
LOS ANGELES CA
90020-1912
US

V. Phone/Fax

Practice location:
  • Phone: 213-996-1343
  • Fax: 213-996-1350
Mailing address:
  • Phone: 213-996-1343
  • Fax: 213-996-1350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS 17759
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: