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NPI Code Detail

MEDICARE: MS. MONICA CORTES ARDILLA LCSW

MEDICARE: MS. MONICA CORTES ARDILLA 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
1101YM0800XMental Health Counselor31653CA
21041C0700XClinical Social WorkerLCSW 76467CA

General Provider Information

NPI Number : 1528243532
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MONICA CORTES ARDILLA LCSW
Provider Business Mailing Address
First Line : 12099 W WASHINGTON BLVD STE 200
Second Line :
City : LOS ANGELES
State : CA
Zip : 90066-2622
Country : US
Telephone Number : 310-437-7000
Fax Number : 310-313-7652
Provider Business Practice Location Address
First Line : 12099 W WASHINGTON BLVD STE 200
Second Line :
City : LOS ANGELES
State : CA
Zip : 90066-2622
Country : US
Telephone Number : 310-437-7000
Fax Number : 310-313-7652
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2008
Last Update Date : 05/10/2017

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