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NPI Code Detail

MEDICARE: MRS. CONSTANZA PATRICIA WHITWOOD

MEDICARE: MRS. CONSTANZA PATRICIA WHITWOOD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor77911CA

General Provider Information

NPI Number : 1043460587
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CONSTANZA PATRICIA WHITWOOD
Provider Business Mailing Address
First Line : 2929 WESTMINSTER AVE UNIT 3191
Second Line :
City : SEAL BEACH
State : CA
Zip : 90740-9148
Country : US
Telephone Number : 562-386-5887
Fax Number :
Provider Business Practice Location Address
First Line : 5500 E ATHERTON ST STE 227B
Second Line :
City : LONG BEACH
State : CA
Zip : 90815-4018
Country : US
Telephone Number : 562-386-5887
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2008
Last Update Date : 01/13/2025

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Directions to “ MRS. CONSTANZA PATRICIA WHITWOOD ” Practice Location

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