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General NPI Number Information
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NPI Number | 1942470034
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Entity Type | Individual
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Provider Name | MARIBEL BRACAMONTE MSW, ACSW
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Gender | Female
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 08/15/2012
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Provider Practice Location Address
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Address Line | 8319 ALONDRA BLVD
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City | PARAMOUNT
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State | CA
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Zip | 90723-4403
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Country | US
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Telephone | 562-634-9774
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4176
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City | BELLFLOWER
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State | CA
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Zip | 90707-4176
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Country | US
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Telephone | 562-572-8743
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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 | ASW29328
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License Number State | CA
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