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NPI Code Detail

MEDICARE: JULIA-ELISE CHILDS LCSW

MEDICARE: JULIA-ELISE CHILDS 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 Worker

General Provider Information

NPI Number : 1306515663
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIA-ELISE CHILDS LCSW
Provider Business Mailing Address
First Line : PO BOX 2395
Second Line :
City : PASADENA
State : CA
Zip : 91102-2395
Country : US
Telephone Number : 805-798-7732
Fax Number :
Provider Business Practice Location Address
First Line : 200 E DEL MAR BLVD STE 160
Second Line :
City : PASADENA
State : CA
Zip : 91105-2507
Country : US
Telephone Number : 626-765-5308
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2021
Last Update Date : 10/31/2023

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Directions to “ JULIA-ELISE CHILDS LCSW” Practice Location

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