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General NPI Number Information
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NPI Number | 1699807305
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Entity Type | Individual
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Provider Name | NINA ELSIE CHUQUIMIA
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Gender | Female
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 06/05/2013
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Provider Practice Location Address
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Address Line | 210 S DE LACEY AVE #110
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City | PASADENA
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State | CA
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Zip | 91105-2048
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Country | US
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Telephone | 626-395-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 12400 VENTURA BLVD #177
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City | STUDIO CITY
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State | CA
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Zip | 91604-2406
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Country | US
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Telephone | 818-662-0778
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | ASW 23179
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License Number State | CA
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