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NPI Code Detail

MEDICARE: MS. NICOLE GUTMAN MSW

MEDICARE:  MS. NICOLE  GUTMAN  MSW
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 Counselor20226CA
21041C0700XClinical Social Worker27217CA

General Provider Information

NPI Number : 1093899353
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NICOLE GUTMAN MSW
Provider Business Mailing Address
First Line : 529 MAPLE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90013-1511
Country : US
Telephone Number : 213-430-6723
Fax Number : 213-895-6236
Provider Business Practice Location Address
First Line : 529 MAPLE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90013-1511
Country : US
Telephone Number : 213-430-6723
Fax Number : 213-895-6236
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2006
Last Update Date : 03/20/2013

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Directions to “ MS. NICOLE GUTMAN MSW” Practice Location

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