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General NPI Number Information
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NPI Number | 1750440939
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Entity Type | Organization
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Legal Business Name | JEWISH FAMILY CHILDRENS SERVICE LONG BEACH
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3801 E WILLOW ST.
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City | LONG BEACH
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State | CA
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Zip | 90815
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Country | US
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Telephone | 562-427-7916
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Fax | 562-427-7910
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Provider Business Mailing Address
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Address Line | 3801 E WILLOW ST.
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City | LONG BEACH
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State | CA
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Zip | 90815
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Country | US
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Telephone | 562-427-7916
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Fax | 562-427-7910
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL SERVICES
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Name | MR. DAVID LAWRENCE LATTMAN
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Credential |
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Telephone | 562-427-7916
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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 | 8346
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License Number State | CA
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