MEDICARE: MS. CYNTHIA EUNICE JUAREZ 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	28795	CA
2	1041C0700X	Clinical Social Worker	28795
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1225157571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CYNTHIA EUNICE JUAREZ LCSW

Provider Business Mailing Address
First Line	:	2629 CLARENDON AVE
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-4119
Country	:	US
Telephone Number	:	323-584-3700
Fax Number	:

Provider Business Practice Location Address
First Line	:	2629 CLARENDON AVE
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-4119
Country	:	US
Telephone Number	:	323-584-3700
Fax Number	:

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

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	09/04/2025

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