Healthcare Provider Details

I. General information

NPI: 1912823121
Provider Name (Legal Business Name): EMILY GEORDANA HERRARTE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6617 BAKMAN AVE APT 2
NORTH HOLLYWOOD CA
91606-1831
US

IV. Provider business mailing address

6617 BAKMAN AVE APT 2
NORTH HOLLYWOOD CA
91606-1831
US

V. Phone/Fax

Practice location:
  • Phone: 818-430-8473
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW135751
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: