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General NPI Number Information
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NPI Number | 1508795980
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Entity Type | Individual
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Provider Name | MIRIAM PATINO ASW
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Gender | Female
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Dates
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Enumeration Date | 05/14/2026
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Last Update Date | 05/14/2026
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Provider Practice Location Address
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Address Line | 1005 EAST ROSECRANS AVENUE
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City | COMPTON
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State | CA
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Zip | 90221
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Country | US
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Telephone | 310-627-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 1114 S TRURO AVE
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City | INGLEWOOD
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State | CA
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Zip | 90301-3735
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Country | US
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Telephone | 424-204-2604
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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 | 389181
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License Number State | CA
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