Healthcare Provider Details

I. General information

NPI: 1427337955
Provider Name (Legal Business Name): ASHLIE NEWMAN MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2011
Last Update Date: 09/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12450 VAN NUYS BLVD STE 100
PACOIMA CA
91331-1392
US

IV. Provider business mailing address

12450 VAN NUYS BLVD STE 100
PACOIMA CA
91331-1392
US

V. Phone/Fax

Practice location:
  • Phone: 626-395-7100
  • Fax:
Mailing address:
  • Phone: 818-896-8366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW72969
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW33388
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: