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General NPI Number Information
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NPI Number | 1396874053
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Entity Type | Individual
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Provider Name | CHARITY LYNN WANG MSW
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Gender | Female
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 625 FAIR OAKS AVE STE 300
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City | SOUTH PASADENA
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State | CA
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Zip | 91030-5805
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Country | US
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Telephone | 626-395-7100
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Fax | 626-799-1441
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Provider Business Mailing Address
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Address Line | 1937 DELMESA AVE
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City | HACIENDA HTS
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State | CA
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Zip | 91745-4223
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Country | US
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Telephone | 626-330-8595
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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 | ASW 19561
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License Number State | CA
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