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NPI Code Detail

MEDICARE: BRIAR GROSSMAN M.S.W.

MEDICARE: BRIAR GROSSMAN M.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 WorkerLCS14655CA

General Provider Information

NPI Number : 1376700252
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAR GROSSMAN M.S.W.
Provider Business Mailing Address
First Line : 20969 VENTURA BLVD
Second Line : SUITE 202
City : WOODLAND HILLS
State : CA
Zip : 91364-2305
Country : US
Telephone Number : 310-863-4800
Fax Number : 818-222-8733
Provider Business Practice Location Address
First Line : 20969 VENTURA BLVD
Second Line : SUITE 202
City : WOODLAND HILLS
State : CA
Zip : 91364-2305
Country : US
Telephone Number : 310-863-4800
Fax Number : 818-222-8733
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2008
Last Update Date : 05/19/2008

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