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General NPI Number Information
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NPI Number | 1245384809
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Entity Type | Individual
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Provider Name | JOSEPH AVERY B.S.
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Gender | Male
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 11/09/2022
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Provider Practice Location Address
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Address Line | 4235 EAST COMPTON BLVD
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City | COMPTON
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State | CA
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Zip | 90221
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Country | US
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Telephone | 310-509-3764
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Fax | 310-632-0356
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Provider Business Mailing Address
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Address Line | 19206 MIDTOWN AVE
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City | CARSON
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State | CA
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Zip | 90746
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Country | US
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Telephone | 323-226-8826
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Fax | 323-226-2992
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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