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General NPI Number Information
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NPI Number | 1124179577
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Entity Type | Individual
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Provider Name | PEGGY ANTELMAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3424 W CARSON ST SUITE 580
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City | TORRANCE
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State | CA
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Zip | 90503-5701
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Country | US
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Telephone | 310-784-8856
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Fax | 310-326-6368
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Provider Business Mailing Address
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Address Line | 1363 HUNT TER
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City | HARBOR CITY
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State | CA
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Zip | 90710-2471
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Country | US
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Telephone | 310-326-4607
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS11801
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License Number State | CA
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