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General NPI Number Information
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NPI Number | 1396656583
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Entity Type | Organization
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Legal Business Name | CHRISTINE'S GOOD LICENSED CLINICAL SOCIAL WORKER INC.
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Dates
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Enumeration Date | 09/15/2026
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Last Update Date | 09/15/2026
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Provider Practice Location Address
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Address Line | 354 N CARMELITA AVE
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City | LOS ANGELES
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State | CA
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Zip | 90063-3410
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Country | US
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Telephone | 510-305-6480
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Fax | 510-743-7162
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Provider Business Mailing Address
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Address Line | 10316 SEPULVEDA BLVD # 406
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City | MISSION HILLS
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State | CA
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Zip | 91345-2422
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Country | US
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Telephone | 510-305-6480
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Fax | 510-743-7162
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | CHRISTINE A VELASQUEZ
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Credential | LCSW
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Telephone | 510-305-6480
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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 |
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License Number State |
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