Healthcare Provider Details

I. General information

NPI: 1205028107
Provider Name (Legal Business Name): MISS PHYLISSA JUNE SAVEDRA I
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2007
Last Update Date: 08/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10511 COLIMA RD
WHITTIER CA
90604
US

IV. Provider business mailing address

10511 COLIMA RD
WHITTIER CA
90604
US

V. Phone/Fax

Practice location:
  • Phone: 562-692-0383
  • Fax: 562-692-0380
Mailing address:
  • Phone: 562-692-0383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: