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General NPI Number Information
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NPI Number | 1194856716
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Entity Type | Individual
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Provider Name | ANA SOFIA CERVANTES ACSW
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Gender | Female
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 21520 PIONEER BLVD STE 110
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City | HAWAIIAN GARDENS
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State | CA
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Zip | 90716-2604
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Country | US
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Telephone | 562-754-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 4378 CLARA ST APT 3
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City | CUDAHY
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State | CA
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Zip | 90201-5096
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Country | US
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Telephone | 323-496-7172
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | ASW 31321
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License Number State | CA
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