MEDICARE: PATRICIA ALBA 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
1	1041C0700X	Clinical Social Worker	26224	CA

General Provider Information

NPI Number	:	1124205885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA ALBA LCSW

Provider Business Mailing Address
First Line	:	5831 NATICK AVE
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91411-3110
Country	:	US
Telephone Number	:	818-406-8543
Fax Number	:

Provider Business Practice Location Address
First Line	:	14500 ROSCOE BLVD STE 400
Second Line	:
City	:	PANORAMA CITY
State	:	CA
Zip	:	91402-4194
Country	:	US
Telephone Number	:	818-835-3459
Fax Number	:	818-935-6189

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2008
Last Update Date	:	07/11/2023

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