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General NPI Number Information
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NPI Number | 1366883126
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Entity Type | Individual
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Provider Name | JAGADEV PRAKASH SHARMA LCSW
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Gender | Male
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Dates
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Enumeration Date | 07/09/2013
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 5901 E 7TH ST
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City | LONG BEACH
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State | CA
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Zip | 90822-5201
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Country | US
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Telephone | 562-576-4537
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Fax |
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Provider Business Mailing Address
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Address Line | 17526 NORDHOFF ST
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City | NORTHRIDGE
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State | CA
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Zip | 91325-2903
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Country | US
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Telephone | 818-943-6321
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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 | LCSW88257
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License Number State | CA
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