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General NPI Number Information
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NPI Number | 1023486909
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Entity Type | Individual
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Provider Name | BIVIANA CALLEJA LAGUNAS LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/09/2015
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Last Update Date | 10/07/2021
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Provider Practice Location Address
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Address Line | 400 W 30TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90007-3320
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Country | US
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Telephone | 323-891-6417
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Fax |
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Provider Business Mailing Address
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Address Line | 2599 WALNUT AVE UNIT 339
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City | SIGNAL HILL
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State | CA
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Zip | 90755-3675
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Country | US
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Telephone | 949-241-1127
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 77614
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 97595
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License Number State | CA
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