MEDICARE: MS. ANNA JOAN MANSOUR ASCW

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	386776	CA

General Provider Information

NPI Number	:	1215876859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANNA JOAN MANSOUR ASCW

Provider Business Mailing Address
First Line	:	2929 WESTMINSTER AVE UNIT 3191
Second Line	:
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-9148
Country	:	US
Telephone Number	:	562-386-5887
Fax Number	:

Provider Business Practice Location Address
First Line	:	3840 WOODRUFF AVE STE 204
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-2149
Country	:	US
Telephone Number	:	562-386-5887
Fax Number	:

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

Provider Enumeration Date	:	03/27/2026
Last Update Date	:	03/27/2026

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