Healthcare Provider Details

I. General information

NPI: 1790204576
Provider Name (Legal Business Name): MARGARET ROSS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARGARET GROSS

II. Dates (important events)

Enumeration Date: 09/13/2017
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 FAIR OAKS AVE 284
SOUTH PASADENA CA
91030-3311
US

IV. Provider business mailing address

1107 FAIR OAKS AVE # 284
SOUTH PASADENA CA
91030-3311
US

V. Phone/Fax

Practice location:
  • Phone: 408-797-9352
  • Fax:
Mailing address:
  • Phone: 408-797-9352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW110993
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: