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General NPI Number Information
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NPI Number | 1467142737
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Entity Type | Organization
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Legal Business Name | PAUL MICHAEL MASTROFRANCESCO, LICENSED CLINICAL SOCIAL WORKER PC
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Dates
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Enumeration Date | 05/10/2023
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Last Update Date | 05/10/2023
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Provider Practice Location Address
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Address Line | 11301 W OLYMPIC BLVD # 121-303
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City | LOS ANGELES
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State | CA
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Zip | 90064-1653
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Country | US
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Telephone | 424-291-2219
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Fax |
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Provider Business Mailing Address
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Address Line | 1851 COMSTOCK AVE # B
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City | LOS ANGELES
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State | CA
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Zip | 90025-5014
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Country | US
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Telephone | 424-291-2219
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Fax |
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Authorized Official
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Title or Position | OWNER/CONSULTANT
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Name | PAUL MICHAEL MASTROFRANCESCO
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Credential | LCSW
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Telephone | 424-291-2219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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