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General NPI Number Information
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NPI Number | 1962953133
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Entity Type | Individual
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Provider Name | JENNIE FARBER KOSKO MSW SOCIAL WORK INTE
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Gender | Female
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Dates
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Enumeration Date | 10/21/2016
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 6500 WILSHIRE BLVD FL 19
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City | LOS ANGELES
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State | CA
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Zip | 90048-4920
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Country | US
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Telephone | 800-270-9256
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Fax | 805-855-4771
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Provider Business Mailing Address
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Address Line | 5504 DARTMOUTH DR
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City | SAN JOSE
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State | CA
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Zip | 95118-3331
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Country | US
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Telephone | 800-270-9256
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | RA858809
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License Number State | CA
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