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General NPI Number Information
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NPI Number | 1033312822
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Entity Type | Individual
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Provider Name | WENDY NAN BLOCK L.C.S,W.
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Gender | Female
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 4132 KATELLA AVE SUITE 206
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-3426
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Country | US
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Telephone | 562-310-5505
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Fax | 562-799-0747
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Provider Business Mailing Address
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Address Line | 3032 KEMPTON DR
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-4622
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Country | US
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Telephone | 562-799-0747
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Fax | 562-799-0747
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS14643
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License Number State | CA
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