Healthcare Provider Details

I. General information

NPI: 1689708356
Provider Name (Legal Business Name): LORI ANTIONETTE MELENDREZ-ALLEMAND LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10155 COLIMA RD
WHITTIER CA
90603-2063
US

IV. Provider business mailing address

11831 WHITLEY ST
WHITTIER CA
90601-2720
US

V. Phone/Fax

Practice location:
  • Phone: 562-692-0383
  • Fax:
Mailing address:
  • Phone: 562-695-9788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS19122
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: