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General NPI Number Information
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NPI Number | 1669972162
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Entity Type | Individual
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Provider Name | DELLAYNNAH CLEVELAND ACSW
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Gender | Female
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Dates
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Enumeration Date | 02/20/2018
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Last Update Date | 06/26/2024
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Provider Practice Location Address
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Address Line | 43909 30TH ST W
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City | LANCASTER
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State | CA
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Zip | 93536-5843
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Country | US
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Telephone | 661-384-4479
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Fax |
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Provider Business Mailing Address
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Address Line | 4859 W SLAUSON AVE
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City | LOS ANGELES
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State | CA
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Zip | 90056-1290
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Country | US
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Telephone | 661-384-4479
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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 | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | ASW112934
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License Number State | CA
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