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NPI Code Detail

MEDICARE: MS. AIMEE SIMONE PHILLIPS M.S.W,, L.C.S.W

MEDICARE: MS. AIMEE SIMONE PHILLIPS M.S.W,, 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 Worker
21041C0700XClinical Social WorkerLCS26972CA

General Provider Information

NPI Number : 1104940204
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AIMEE SIMONE PHILLIPS M.S.W,, L.C.S.W
Provider Business Mailing Address
First Line : 6519 8TH AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90043-4313
Country : US
Telephone Number : 213-694-0045
Fax Number :
Provider Business Practice Location Address
First Line : 6519 SOUTH 8TH AVENUE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90043
Country : US
Telephone Number : 213-694-0045
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 06/14/2011

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