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NPI Code Detail

MEDICARE: MS. ELISA VARTANIAN LIMA L.C.S.W.

MEDICARE: MS. ELISA VARTANIAN LIMA L.C.S.W.
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 WorkerASW 19439CA
21041C0700XClinical Social Worker26991CA

General Provider Information

NPI Number : 1245356633
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELISA VARTANIAN LIMA L.C.S.W.
Provider Business Mailing Address
First Line : 5500 E ATHERTON ST STE 227B
Second Line :
City : LONG BEACH
State : CA
Zip : 90815-4018
Country : US
Telephone Number : 562-852-3492
Fax Number : 855-270-6689
Provider Business Practice Location Address
First Line : 5500 E ATHERTON ST STE 227B
Second Line :
City : LONG BEACH
State : CA
Zip : 90815-4018
Country : US
Telephone Number : 562-852-3492
Fax Number : 855-270-6689
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2007
Last Update Date : 02/25/2019

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