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NPI Code Detail

MEDICARE: MS. JENNIFER ARIANNA RAY PHD, LCSW

MEDICARE: MS. JENNIFER ARIANNA RAY PHD, 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 WorkerCA

General Provider Information

NPI Number : 1538417530
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER ARIANNA RAY PHD, LCSW
Provider Business Mailing Address
First Line : 3001 W VERNON AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90008-5293
Country : US
Telephone Number : 323-954-1464
Fax Number :
Provider Business Practice Location Address
First Line : 3001 W VERNON AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90008-5293
Country : US
Telephone Number : 626-349-0506
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2012
Last Update Date : 08/28/2024

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