Healthcare Provider Details

I. General information

NPI: 1972909133
Provider Name (Legal Business Name): MIRANDA PALMIRA HARWOOD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2014
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 GREAT AMERICA PKWY STE 320
SANTA CLARA CA
95054-1140
US

IV. Provider business mailing address

3114 5TH ST
SANTA MONICA CA
90405-5606
US

V. Phone/Fax

Practice location:
  • Phone: 424-424-1577
  • Fax:
Mailing address:
  • Phone: 310-210-5824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW83132
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: