Healthcare Provider Details

I. General information

NPI: 1124899380
Provider Name (Legal Business Name): LORI MICHIYE OSHIRO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2024
Last Update Date: 01/15/2024
Certification Date: 01/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13100 STUDEBAKER RD
NORWALK CA
90650-2500
US

IV. Provider business mailing address

13100 STUDEBAKER RD
NORWALK CA
90650-2500
US

V. Phone/Fax

Practice location:
  • Phone: 562-868-3751
  • Fax: 562-864-0750
Mailing address:
  • Phone: 562-868-3751
  • Fax: 562-864-0750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS17328
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: