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NPI Code Detail

MEDICARE: SUSAN CHERYL BALTIMORE L.C.S.W.

MEDICARE: SUSAN CHERYL BALTIMORE L.C.S.W.
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
11041C0700XClinical Social WorkerLCS9118CA

General Provider Information

NPI Number : 1083731574
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN CHERYL BALTIMORE L.C.S.W.
Provider Business Mailing Address
First Line : 39700 ELNA WAY
Second Line :
City : CATHEDRAL CITY
State : CA
Zip : 92234-2426
Country : US
Telephone Number : 310-780-9110
Fax Number :
Provider Business Practice Location Address
First Line : 39700 ELNA WAY
Second Line :
City : CATHEDRAL CITY
State : CA
Zip : 92234-2426
Country : US
Telephone Number : 310-780-9110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2007
Last Update Date : 02/19/2026

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