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General NPI Number Information
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NPI Number | 1518196948
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Entity Type | Individual
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Provider Name | LESLIE CELIA BAERWITZ
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Gender | Female
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Dates
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Enumeration Date | 07/07/2009
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Last Update Date | 05/05/2011
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Provider Practice Location Address
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Address Line | 2500 WILSHIRE BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90057-4303
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Country | US
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Telephone | 213-639-0207
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Fax |
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Provider Business Mailing Address
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Address Line | 408 NORWICH DR
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90048-1902
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Country | US
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Telephone | 818-388-6442
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 30343
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License Number State | CA
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