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General NPI Number Information
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NPI Number | 1700919875
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Entity Type | Individual
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Provider Name | HUMIE TO MSW
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Gender | Female
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 130 W VICTORIA ST
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City | GARDENA
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State | CA
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Zip | 90248-3523
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Country | US
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Telephone | 310-715-2020
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Fax | 310-327-4723
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Provider Business Mailing Address
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Address Line | 8671 PACHECO AVE
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City | WESTMINSTER
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State | CA
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Zip | 92683-6309
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Country | US
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Telephone | 714-925-2705
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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 | 17575
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License Number State | CA
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