Healthcare Provider Details

I. General information

NPI: 1023399862
Provider Name (Legal Business Name): GLORIA LING LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2011
Last Update Date: 09/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6133 IVAR AVE
TEMPLE CITY CA
91780-1524
US

IV. Provider business mailing address

18047 ESPITO ST
ROWLAND HEIGHTS CA
91748-1820
US

V. Phone/Fax

Practice location:
  • Phone: 626-224-8413
  • Fax:
Mailing address:
  • Phone: 626-224-8413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number26496
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: