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NPI Code Detail

MEDICARE: MAYA WEISFELNER LCSW

MEDICARE: MAYA WEISFELNER 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 WorkerLCS28267CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ENK1761OTHERCADEPARTMENT MENTAL HEALTH

General Provider Information

NPI Number : 1235269465
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAYA WEISFELNER LCSW
Provider Business Mailing Address
First Line : 6043 HOLLYWOOD BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90028-5411
Country : US
Telephone Number : 949-466-0530
Fax Number :
Provider Business Practice Location Address
First Line : 6043 HOLLYWOOD BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90028-5411
Country : US
Telephone Number : 949-466-0530
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 09/23/2013

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