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General NPI Number Information
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NPI Number | 1205069911
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Entity Type | Individual
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Provider Name | NELIDA PATRICIA PADRON LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/27/2009
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Last Update Date | 04/09/2020
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Provider Practice Location Address
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Address Line | 100 W FOOTHILL BLVD STE 104
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City | SAN DIMAS
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State | CA
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Zip | 91773-1170
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Country | US
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Telephone | 626-671-2385
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Fax |
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Provider Business Mailing Address
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Address Line | 1220 CANYON WAY
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City | POMONA
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State | CA
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Zip | 91768-1403
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Country | US
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Telephone | 323-420-8260
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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 |
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License Number State |
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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 | 74432
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License Number State | CA
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