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General NPI Number Information
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NPI Number | 1316745235
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Entity Type | Individual
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Provider Name | MIREYA ENRIQUEZ ACSW
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Gender | Female
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Dates
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Enumeration Date | 03/05/2025
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 15720 VENTURA BLVD STE 420
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City | ENCINO
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State | CA
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Zip | 91436-4711
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Country | US
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Telephone | 818-927-0478
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Fax |
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Provider Business Mailing Address
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Address Line | 3601 ARGENT ST
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City | BAKERSFIELD
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State | CA
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Zip | 93304-6403
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Country | US
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Telephone | 661-979-7787
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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 | 109342
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License Number State | CA
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