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General NPI Number Information
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NPI Number | 1821282302
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Entity Type | Individual
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Provider Name | MAUREEN DOLORES BURRUEL MSW
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Gender | Female
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Dates
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Enumeration Date | 08/28/2007
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Last Update Date | 01/23/2008
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Provider Practice Location Address
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Address Line | 11301 WILSHIRE BLVD BLDG 500
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City | LOS ANGELES
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State | CA
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Zip | 90073-1003
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Country | US
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Telephone | 310-478-3711
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Fax |
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Provider Business Mailing Address
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Address Line | 4619 COOLIDGE AVE
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City | CULVER CITY
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State | CA
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Zip | 90230-5114
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Country | US
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Telephone | 310-993-9668
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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 | 22329
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License Number State | CA
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