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General NPI Number Information
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NPI Number | 1336256999
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Entity Type | Individual
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Provider Name | MARIA ROSARIO POZO HUMPHREYS LCSW, PHD
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Gender | Female
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 06/27/2020
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Provider Practice Location Address
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Address Line | 611 WILSHIRE BLVD STE 309
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City | LOS ANGELES
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State | CA
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Zip | 90017-2908
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Country | US
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Telephone | 562-234-1999
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Fax |
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Provider Business Mailing Address
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Address Line | 800 W 1ST ST UNIT 1805
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City | LOS ANGELES
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State | CA
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Zip | 90012-2481
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Country | US
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Telephone | 562-234-1999
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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 | LCSW 14157
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License Number State | CA
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