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General NPI Number Information
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NPI Number | 1447816061
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Entity Type | Individual
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Provider Name | DENEDRIA RENEE BANKS LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/20/2019
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Last Update Date | 05/20/2019
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Provider Practice Location Address
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Address Line | 300 S IDAHO ST APT 10
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City | LA HABRA
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State | CA
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Zip | 90631-5252
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Country | US
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Telephone | 310-686-6141
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2584
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City | DOWNEY
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State | CA
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Zip | 90242-1584
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Country | US
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Telephone |
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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 | LCSW76721
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License Number State | CA
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