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General NPI Number Information
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NPI Number | 1013297266
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Entity Type | Organization
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Legal Business Name | CLAUDIA JOAN ROSA-BIENENFELD, MSW LICENSED CLINICAL SOCIAL WORKER, A P
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Dates
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Enumeration Date | 08/19/2011
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Last Update Date | 07/26/2013
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Provider Practice Location Address
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Address Line | 11911 SAN VICENTE BLVD SUITE 280
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City | LOS ANGELES
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State | CA
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Zip | 90049-5086
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Country | US
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Telephone | 818-487-2593
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Fax |
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Provider Business Mailing Address
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Address Line | 10153 1/2 RIVERSIDE DRIVE, SUITE 198
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City | TOLUCA LAKE
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State | CA
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Zip | 91602-2561
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Country | US
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Telephone |
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Fax | 818-487-8591
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Authorized Official
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Title or Position | CEO
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Name | CLAUDIA JOAN ROSA-BIENENFELD
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Credential | MSW, LCSW
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Telephone | 818-487-2593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LCS19209
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License Number State | CA
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