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General NPI Number Information
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NPI Number | 1225345671
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Entity Type | Individual
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Provider Name | ROBERTO ERYAN ATTALLA LCSW
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Gender | Male
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Dates
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Enumeration Date | 09/07/2010
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Last Update Date | 12/27/2023
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Provider Practice Location Address
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Address Line | 1200 WILSHIRE BLVD SUITE 100
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City | LOS ANGELES
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State | CA
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Zip | 90017-1908
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Country | US
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Telephone | 213-481-7464
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Fax |
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Provider Business Mailing Address
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Address Line | 6415 OAK AVE
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City | TEMPLE CITY
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State | CA
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Zip | 91780-1338
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Country | US
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Telephone | 626-215-2967
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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 | 119012
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 119012
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License Number State | CA
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