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General NPI Number Information
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NPI Number | 1972858918
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Entity Type | Individual
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Provider Name | CHERYL CHICK SJOBERG M.S.W., L.I.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 07/16/2012
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Last Update Date | 07/16/2012
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Provider Practice Location Address
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Address Line | 315 E. TEMPLE STREET V.A. AMBULATORY CARE CENTER
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City | LOS ANGELES
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State | CA
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Zip | 90012-3328
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Country | US
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Telephone | 213-253-5050
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Fax | 213-253-5123
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Provider Business Mailing Address
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Address Line | 315 E. TEMPLE STREET V.A. AMBULATORY CARE CENTER
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City | LOS ANGELES
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State | CA
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Zip | 90012-3328
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Country | US
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Telephone | 213-253-5050
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Fax | 213-253-5123
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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 | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number | 00004750
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License Number State | WA
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