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NPI Code Detail

MEDICARE: DINA MARIE NELLI LCSW

MEDICARE: DINA MARIE NELLI LCSW
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 WorkerLCS20168CA

General Provider Information

NPI Number : 1114006178
Entity Type Code : Individual
Provider Name (Legal Business Name) : DINA MARIE NELLI LCSW
Provider Business Mailing Address
First Line : 10605 BALBOA BLVD STE 100
Second Line :
City : GRANADA HILLS
State : CA
Zip : 91344-6367
Country : US
Telephone Number : 818-832-6184
Fax Number : 818-832-6197
Provider Business Practice Location Address
First Line : 10605 BALBOA BLVD STE 100
Second Line :
City : GRANADA HILLS
State : CA
Zip : 91344-6367
Country : US
Telephone Number : 818-832-6184
Fax Number : 818-832-6197
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2006
Last Update Date : 06/14/2021

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Directions to “ DINA MARIE NELLI LCSW” Practice Location

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