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General NPI Number Information
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NPI Number | 1689437998
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Entity Type | Organization
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Legal Business Name | COMMON GOOD THERAPY, A LICENSED CLINICAL SOCIAL WORK CORPORATION
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Dates
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Enumeration Date | 01/31/2024
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 626 W LANCASTER BLVD # 52
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City | LANCASTER
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State | CA
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Zip | 93534-3108
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Country | US
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Telephone | 323-388-3832
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Fax |
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Provider Business Mailing Address
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Address Line | 626 W LANCASTER BLVD # 52
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City | LANCASTER
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State | CA
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Zip | 93534-3108
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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 | DIRECTOR
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Name | MISS GABRIELA MUNIZ
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Credential | LCS
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Telephone | 323-388-3832
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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 |
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License Number State |
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