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NPI Code Detail

MEDICARE: IRIS INDIRA ROJAS BERTRAND LCSW

MEDICARE: IRIS INDIRA ROJAS BERTRAND 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 Worker70136CA

General Provider Information

NPI Number : 1366567901
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRIS INDIRA ROJAS BERTRAND LCSW
Provider Business Mailing Address
First Line : 3200 MOTOR AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90034-3740
Country : US
Telephone Number : 310-836-1223
Fax Number :
Provider Business Practice Location Address
First Line : 3200 MOTOR AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90034-3740
Country : US
Telephone Number : 310-836-1223
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 06/18/2023

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Directions to “ IRIS INDIRA ROJAS BERTRAND LCSW” Practice Location

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