MEDICARE: HANNAH GRACE CICCIARI

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

General Provider Information

NPI Number	:	1265261705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH GRACE CICCIARI

Provider Business Mailing Address
First Line	:	679 S NEW HAMPSHIRE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90005-1355
Country	:	US
Telephone Number	:	626-753-5387
Fax Number	:

Provider Business Practice Location Address
First Line	:	679 S NEW HAMPSHIRE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90005-1355
Country	:	US
Telephone Number	:	626-753-5387
Fax Number	:

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

Provider Enumeration Date	:	08/01/2024
Last Update Date	:	06/09/2026

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Directions to “ HANNAH GRACE CICCIARI ” Practice Location

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