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General NPI Number Information
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NPI Number | 1285152116
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Entity Type | Individual
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Provider Name | CARLOTTA JEAN CHILDS
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Gender | Female
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Dates
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Enumeration Date | 08/30/2017
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Last Update Date | 08/30/2017
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Provider Practice Location Address
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Address Line | 550 S VERMONT AVE
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City | LOS ANGELES
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State | CA
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Zip | 90020-1912
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Country | US
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Telephone | 213-738-4851
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Fax | 213-387-1297
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Provider Business Mailing Address
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Address Line | 6666 RADLOCK AVE
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City | LOS ANGELES
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State | CA
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Zip | 90056-2236
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Country | US
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Telephone | 310-908-6239
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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 | 8601
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License Number State | CA
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