Healthcare Provider Details

I. General information

NPI: 1063969889
Provider Name (Legal Business Name): CLAUDIA J FLORES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2016
Last Update Date: 10/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14600 SHERMAN WAY STE 100D
VAN NUYS CA
91405-2283
US

IV. Provider business mailing address

13832 PADDOCK ST
SYLMAR CA
91342-2216
US

V. Phone/Fax

Practice location:
  • Phone: 818-374-6901
  • Fax:
Mailing address:
  • Phone: 181-844-7763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW74208
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: